Individual
SETH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
330 N WABASH AVE STE 110, MARION, IN 46952-2677
(765) 664-1201
Mailing address
6308 WOODCHUCK DR, PENDLETON, IN 46064-9076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
10005011A
IN
Other
Enumeration date
06/26/2025
Last updated
12/10/2025
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