Individual
REBECCA HEROLD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1160 E 3900 S STE G200, SALT LAKE CITY, UT 84124-1224
(801) 268-7766
(801) 270-3395
Mailing address
PO BOX 742382, ATLANTA, GA 30374-2382
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
44442
CO
207RN0300X
Nephrology Physician
Primary
7549060
UT
207RN0300X
Nephrology Physician
N2671
TX
Other
Enumeration date
01/26/2007
Last updated
11/27/2020
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