Individual
STEPHEN ALAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
31963
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000023150
BOSTON MEDICAL CENTER HEA
—
01
—
10035727
CDPHP
—
01
—
14570
HEALTH NEW ENGLAND
—
01
—
151131
HARVARD
—
01
—
175300
MVP
—
01
—
546172
AETNA US HEALTHCARE
—
01
—
703730
CONNECTICARE
—
01
—
773834
TUFTS
—
01
—
9724273
MASS HEALTH
—
05
—
9724273
—
MA
01
—
9762698003
CEGNA HEALTHCARE
—
01
—
P811505
OXFORD
—
Enumeration date
08/18/2006
Last updated
07/08/2007
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