Organization
GENE MOORE MD P LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEB A CAISE (OFFICE MANAGER)
(802) 864-7080
Entity
Organization
Contact information
Practice address
28 SO WILLIAMS ST, BURLINGTON, VT 05401
(802) 864-7080
(802) 863-0411
Mailing address
28 S WILLIAMS ST, BURLINGTON, VT 05401-3486
(802) 864-7080
(802) 863-0411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042010189
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00058102
BLUE CROSS BLUE SHIELD
VT
05
—
OVN2573
—
VT
Enumeration date
07/12/2017
Last updated
07/21/2022
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