Individual
SHAWN THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7375 W US 52, NEW PALESTINE, IN 46163-8950
(317) 861-4171
(317) 861-5325
Mailing address
1 MEMORIAL SQ STE 50, GREENFIELD, IN 46140-1357
(317) 468-6257
(317) 468-6268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005910B
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2017
Last updated
06/30/2020
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