Individual
CHARLES DANIEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7457
(205) 348-1770
Mailing address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7457
(205) 330-6400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-124776
AL
Other
Enumeration date
01/29/2019
Last updated
07/20/2022
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