Individual
JOHN THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
15 PARKMAN STREET, WANG 435, MASSACHUSETTS GENERAL HOSPITAL/DIV OF PLASTIC SURGERY, BOSTON, MA 02114-3117
(877) 424-5678
Mailing address
15 PARKMAN STREET, WANG 435, MASSACHUSETTS GENERAL HOSPITAL/DIV OF PLASTIC SURGERY, BOSTON, MA 02114-3117
(877) 424-5678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009651-1
NY
Other
Enumeration date
07/10/2006
Last updated
04/20/2017
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