Individual
D. WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
(303) 761-6322
Mailing address
10700 E GEDDES AVE STE 200, ENGLEWOOD, CO 80112-3861
(303) 761-9190
(303) 761-6278
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2096
CO
363A00000X
Physician Assistant
Primary
2096
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29404037
—
NM
05
—
59936363
—
CO
Enumeration date
02/06/2006
Last updated
11/01/2007
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