Individual
LEANN RUTH DEAL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3252 WELLONS BLVD, NEW BERN, NC 28562-5234
(252) 636-2664
(252) 636-8305
Mailing address
PO BOX 12248, NEW BERN, NC 28561-2248
(252) 636-2664
(252) 636-8305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39041
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60376
BCBS OF NC
NC
05
—
8960376
—
NC
Enumeration date
05/26/2006
Last updated
03/21/2014
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