Individual
RICHARD MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3931 LOUISIANA AVE S, SUITE W300, ST LOUIS PARK, MN 55426-4375
(952) 993-3265
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
34906
MN
Other
Enumeration date
12/29/2005
Last updated
03/05/2012
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