Individual
DAVID EARL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 FOOTHILL BLVD (RESEARCH), GEORGE E. WAHLEN VA HEALTHCARE SYSTEM, SALT LAKE CITY, UT 84148
(801) 582-1565
Mailing address
4875 S 1710 E, HOLLADAY, UT 84117-5911
(435) 632-3647
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
167705-1205
UT
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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