Individual
DR. THOMAS J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON, 2ND FLOOR, BOSTON, MA 02118-2309
(617) 638-7470
(617) 638-7449
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37932
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
37932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110037257A
—
MA
Enumeration date
12/27/2005
Last updated
06/10/2014
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