Individual
MARK C MOORE
Active
Individual
MARK C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME65004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891184A
—
GA
05
—
259293200
—
FL
Enumeration date
07/14/2006
Last updated
10/05/2010
Update your record
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