Individual
DR. DONALD WILSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 W DECATUR ST, MADISON, NC 27025-1913
(336) 548-9618
(336) 548-4877
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831170919
BLUE MEDICARE
NC
01
—
202297D
MEDICARE
NC
05
—
8960207
—
NC
Enumeration date
11/07/2005
Last updated
03/13/2014
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