Organization
AHP - GASTRO GAINESVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK STEPHEN MOORE M.D. (OWNER/PRES.)
(770) 536-8109
Entity
Organization
Contact information
Practice address
660 LANIER PARK DR, GAINESVILLE, GA 30501-2075
(770) 536-8109
(678) 997-2127
Mailing address
3079 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-2215
(770) 945-5330
(877) 820-4154
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
11/30/2011
Last updated
04/18/2012
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