Individual
CHERYL L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21700 NORTHWESTERN HWY, 600, SOUTHFIELD, MI 48075-4906
(248) 559-6664
(248) 559-5628
Mailing address
25925 TELEGRAPH RD, 210, SOUTHFIELD, MI 48034-2518
(248) 746-0342
(248) 746-0308
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301048412
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352153010
—
MI
Enumeration date
08/22/2005
Last updated
08/01/2007
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