Individual
DR. MICHAEL M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1009 BOREL LN, HEALDSBURG, CA 95448-4552
(501) 664-4088
Mailing address
1009 BOREL LN, HEALDSBURG, CA 95448-4552
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
N6971
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111115001
—
AR
01
—
53751C207
MEDICARE
AR
Enumeration date
01/06/2006
Last updated
02/01/2022
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