Individual
JAMEY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
201 S 18TH ST APT 615, PHILADELPHIA, PA 19103-5906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OT020757
PA
Other
Enumeration date
07/03/2021
Last updated
07/03/2021
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