Individual
CODY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 MT HIGHWAY 91 S, DILLON, MT 59725-7379
(140) 668-3300
Mailing address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 293-2436
(304) 293-6702
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
112405
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
01/04/2023
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