Individual
MARLYN JOANNA MOORE
Active
Individual
MARLYN JOANNA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207N00000X
Dermatology Physician
Primary
01084147A
IN
208D00000X
General Practice Physician
01084247A
IN
Other
Enumeration date
04/12/2019
Last updated
08/13/2026
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