Individual
POLLY ANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5330 E STOP 11 RD, INDIANAPOLIS, IN 46237-6345
(317) 893-1900
(317) 893-1901
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
01057207A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01057207A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200476670A
—
IN
Enumeration date
12/02/2005
Last updated
07/28/2023
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