Individual
MARYANNE W MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4000
Mailing address
1717 N DECATUR RD NE, SUITE 204, ATLANTA, GA 30307-1013
(770) 331-1965
(404) 248-3962
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
040745
GA
Other
Enumeration date
08/15/2006
Last updated
06/23/2009
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