Individual
DR. MICHAEL GEOFFREY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BOULEVARD, SUITE 3170, INDIANAPOLIS, IN 46202-5149
(317) 948-3226
(317) 944-2443
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01064904A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200909060
—
IN
Enumeration date
02/25/2007
Last updated
12/22/2020
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