Individual
GLENN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40732 VAN DYKE AVE., STERLING HEIGHTS, MI 48313-3741
(615) 778-4066
Mailing address
5080 SPECTRUM DRIVE, SUITE 1200 WEST TOWER, ADDISON, TX 75001-4648
(800) 232-3550
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
4301041081
MI
Other
Enumeration date
04/10/2007
Last updated
04/14/2009
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