Individual
EDWARD B MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4190 CITY AVE, PHILADELPHIA, PA 19131-1626
(302) 373-7478
Mailing address
4190 CITY AVE, PHILADELPHIA, PA 19131-1626
(302) 373-7478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS018101
PA
Other
Enumeration date
02/26/2013
Last updated
02/02/2018
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