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Individual

RICHARD CHARLES MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
309 EAST SPRUCE, HAILEY, ID 83333-3530
(208) 578-2089
Mailing address
PO BOX 3530, HAILEY, ID 83333-3530

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
44228
MN
207Q00000X
Family Medicine Physician
Primary
6741
MT

Other

Enumeration date
03/07/2007
Last updated
10/29/2018
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