Individual
CHERYL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 742-2132
Mailing address
680 CENTRE STREET, PATHOLOGY DEPARTMENT, BROCKTON, MA 02301-3308
(508) 941-7000
(508) 941-6104
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
016067
ME
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
11761
NH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
216651
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110033126A
—
MA
01
—
11098339
CAQH#
—
05
—
30203266
—
NH
05
—
305920099
—
ME
Enumeration date
11/04/2005
Last updated
04/18/2024
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