Individual
GRAHAM J MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 HOSPITAL DR, SUITE 203, BENNINGTON, VT 05201-5009
(802) 442-3800
(802) 442-3855
Mailing address
140 HOSPITAL DR, SUITE 203, BENNINGTON, VT 05201-5009
(802) 442-3800
(802) 442-3855
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D0060214
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013995
—
VT
05
—
2139979
—
MA
Enumeration date
05/25/2006
Last updated
09/29/2008
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