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Individual

CHARLES H MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA, PHD

Contact information

Practice address
1250 E MARSHALL STREET, ANESTHESIA CRNA, RICHMOND, VA 23298-0509
(804) 628-6975
(804) 628-6969
Mailing address
P O BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024089211
VA

Other

Enumeration date
10/03/2006
Last updated
07/09/2007
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