Individual
BRADLEY TODD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4320 WORNALL RD, STE 530, KANSAS CITY, MO 64111-5941
(816) 932-2836
Mailing address
901 E 104TH ST, MAILSTOP 400, KANSAS CITY, MO 64131-4517
(816) 502-8755
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0429748
KS
208600000X
Surgery Physician
Primary
113158
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922047646
—
MO
Enumeration date
06/06/2006
Last updated
12/05/2017
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