Individual
DR. DANIEL W MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 ROSWELL RD STE 225, MARIETTA, GA 30062-8816
(770) 424-2025
(770) 425-1789
Mailing address
3901 ROSWELL RD STE 225, MARIETTA, GA 30062-8816
(770) 424-2025
(770) 425-1789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
038562
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00608539B
—
GA
Enumeration date
12/11/2006
Last updated
09/08/2021
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