Individual
DR. MARLA J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
(719) 447-8987
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
(719) 447-8987
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
105796
MN
2080P0203X
Pediatric Critical Care Medicine Physician
36444
CO
2080P0203X
Pediatric Critical Care Medicine Physician
CO36444
CO
2080P0203X
Pediatric Critical Care Medicine Physician
MD11545
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32804377
—
CO
Enumeration date
04/13/2006
Last updated
10/27/2011
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