Individual
LORAN PETE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4606 GREENWOOD RD, LOUISVILLE, KY 40258-3726
(502) 937-2209
(502) 933-8714
Mailing address
3430 NEWBURG RD, SUITE 150, LOUISVILLE, KY 40218-2497
(502) 238-3178
(502) 238-3653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24953
KY
207RP1001X
Pulmonary Disease Physician
Primary
24953
KY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
24953
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200003670
INDIANA MEDICAID
IN
Enumeration date
10/05/2006
Last updated
09/11/2018
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