Individual
DR. MICHAEL J MOORE
Active
Individual
DR. MICHAEL J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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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