Individual
DR. ROBERT WILLIAM MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1305
(937) 522-7513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35053512
OH
208M00000X
Hospitalist Physician
Primary
35.053512
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0656286
—
OH
Enumeration date
01/03/2007
Last updated
05/04/2023
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