Individual
DR. D SCOTT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 802-3140
(317) 870-0499
Mailing address
ST VINCENTS EMERGENCY PHYSICIANS INC 4685 RELIABLE PKWY, CHICAGO, IL 60686-0046
(317) 802-3140
(317) 870-6719
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02002731A
IN
207P00000X
Emergency Medicine Physician
1039
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009976045
—
AL
01
—
01182507
AMERIGROUP
GA
05
—
300025719
—
IN
05
—
483409800
—
SC
05
—
483409800B
—
GA
05
—
483409800C
—
GA
05
—
483409800D
—
GA
05
—
O10393
—
SC
Enumeration date
12/20/2006
Last updated
04/23/2020
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