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Individual

STEVEN MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
908 HILLCREST PKWY, DUBLIN, GA 31021-4206
(478) 272-7411
(478) 274-9809
Mailing address
908 HILLCREST PKWY, DUBLIN, GA 31021-4206
(478) 272-7411
(478) 274-9809

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004555
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00411777
RAILROAD MEDICARE
Enumeration date
08/17/2006
Last updated
03/19/2008
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