Individual
DR. BRIAN HAROLD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
813 W 2ND ST, BLOOMINGTON, IN 47403-2212
(812) 330-0303
(812) 330-0404
Mailing address
813 W 2ND ST, BLOOMINGTON, IN 47403-2212
(812) 330-0303
(812) 330-0404
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01060196A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200514350
—
IN
Enumeration date
03/31/2006
Last updated
05/23/2016
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