Individual
MICHAEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
(602) 262-8890
Mailing address
645 E MISSOURI AVE, STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
60351
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087531
—
AZ
Enumeration date
05/03/2016
Last updated
08/18/2021
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