Individual
DR. DANIEL THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845-1714
(260) 425-6030
(260) 425-6028
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01086194A
IN
Other
Enumeration date
04/06/2017
Last updated
10/15/2022
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