Individual
DR. JOHN MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6400 PROSPECT AVE, SUITE 238, KANSAS CITY, MO 64132-1100
(816) 363-4114
(816) 363-5568
Mailing address
6400 PROSPECT AVE, SUITE 238, KANSAS CITY, MO 64132-1100
(816) 363-4114
(816) 363-5568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MDR3B83
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09343022
BCBS INDIVIDUAL ID
MO
Enumeration date
08/16/2005
Last updated
07/08/2007
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