Organization
MOORE SURGICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE E MOORE M.D. (VICE PRESIDENT)
(219) 362-8523
Entity
Organization
Contact information
Practice address
901 LINCOLNWAY, SUITE 304, LA PORTE, IN 46350-3430
(219) 362-8523
(219) 324-9396
Mailing address
901 LINCOLNWAY, SUITE 304, LA PORTE, IN 46350-3430
(219) 362-8523
(219) 324-9396
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
50000416
IN
Other
Enumeration date
02/27/2007
Last updated
08/22/2020
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