Individual
MRS. LAURA M MOORE
Active
Individual
MRS. LAURA M MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
101511
AK
208000000X
Pediatrics Physician
101511
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12268
LICENSE
MT
Enumeration date
10/28/2005
Last updated
04/15/2025
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