Individual
DR. VINCENT PAUL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
7221 ENGLE RD STE 220, FORT WAYNE, IN 46804-2233
(260) 469-8223
(260) 469-8201
Mailing address
7221 ENGLE RD STE 220, FORT WAYNE, IN 46804-2233
(260) 469-8223
(260) 469-8201
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
023438
LA
2085R0202X
Diagnostic Radiology Physician
023438
LA
2085R0202X
Diagnostic Radiology Physician
Primary
ME144253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107111400
—
FL
Enumeration date
05/03/2006
Last updated
08/02/2021
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