Individual
ANNIE ANDERSON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MBA
Contact information
Practice address
12605 E 16TH AVE, WISH CLINIC, UNIVERSITY OF COLORADO HOSPITAL, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2012-00846
NC
207R00000X
Internal Medicine Physician
Primary
DR.0054340
CO
207R00000X
Internal Medicine Physician
MD13905
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153783
—
OR
Enumeration date
08/01/2006
Last updated
10/01/2015
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