Individual
DR. BRADLEY BANCROFT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9 DUNWOODY PARK, SUITE 108, ATLANTA, GA 30338-7407
(770) 393-1988
(770) 399-9638
Mailing address
9 DUNWOODY PARK, SUITE 108, ATLANTA, GA 30338-7407
(770) 393-1988
(770) 399-9638
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
051691
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051691
STATE MEDICAL LICENSE
GA
Enumeration date
03/17/2006
Last updated
03/07/2023
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