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SCOT B MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
350 S LANDMARK AVE, BLOOMINGTON, IN 47403-5001
(812) 334-9995
(812) 335-7604
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01044878
IN
208000000X
Pediatrics Physician
Primary
01044878A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200095050A
IN
Enumeration date
07/08/2005
Last updated
09/02/2022
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