Individual
ARL VAN MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
(704) 334-7800
(704) 414-7512
Mailing address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
(704) 334-7800
(704) 414-7512
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20166
SC
2085R0202X
Diagnostic Radiology Physician
Primary
21689
NC
2085R0202X
Diagnostic Radiology Physician
C-4845
AR
2085R0204X
Vascular & Interventional Radiology Physician
20166
SC
2085R0204X
Vascular & Interventional Radiology Physician
21689
NC
2085R0204X
Vascular & Interventional Radiology Physician
C-4845
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300096407
RR MEDICARE (NC)
NC
05
—
8960178
—
NC
05
—
N21689
—
SC
Enumeration date
07/18/2005
Last updated
12/20/2017
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