Individual
DAVID BAKER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 KELVINGTON WAY, PEACHTREE CITY, GA 30269-5620
(678) 588-4065
Mailing address
209 KELVINGTON WAY, PEACHTREE CITY, GA 30269-5620
(678) 588-4065
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
27227
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00350523E
—
GA
Enumeration date
09/21/2006
Last updated
04/03/2020
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