Individual
DR. MICHAEL J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
131 ORNAC, JOHN CUMMINGS BLDG, CONCORD, MA 01742-4181
(781) 259-0803
Mailing address
PO BOX 9132, BROOKLINE, MA 02446-9132
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29410
MA
2084N0400X
Neurology Physician
Primary
29410
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024368
BMC HEALTHNET
MA
01
—
029410
TUFTS
MA
01
—
05-04349
UNITED HEALTHCARE
MA
01
—
11461
HARVARD PILGRIM
MA
05
—
3196640
—
MA
01
—
B23053
BCBS
MA
Enumeration date
11/10/2005
Last updated
09/27/2012
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