Individual
DR. SCOTT MACLEOD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13699 OLD US 12, CHELSEA, MI 48118
(734) 475-4500
(734) 475-4507
Mailing address
13699 OLD US 12, CHELSEA, MI 48118
(734) 475-4500
(734) 475-4507
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301073339
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024175
MIDWEST HP-MEDICAID
MI
01
—
1220066
PHP
MI
01
—
201711014
TRICARE
MI
01
—
3508144121
BCBS-INDIVIDUAL
MI
05
—
4689652
—
MI
01
—
5526527
AENTA
MI
01
—
6U4708
HAP
—
01
—
OH11422
BCBS/BCN GROUP
—
Enumeration date
05/22/2006
Last updated
08/07/2025
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