Individual
PAUL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 349-8310
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 349-8310
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN630294
PA
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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