Individual
MICHAEL C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2943 SENECA ST, WEST SENECA, NY 14224-1950
(716) 825-3601
(716) 825-2850
Mailing address
2943 SENECA ST, WEST SENECA, NY 14224-1950
(716) 825-3601
(716) 825-2850
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
124157
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010121501
UNIVERA
NY
01
—
2301114
INDEPENDENT HEALTH
NY
01
—
5080261
HEALTHNOW COMMUNITY BLUE
NY
Enumeration date
11/13/2006
Last updated
07/08/2007
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