1942344494 NPI NUMBER - DR. GEORGE MOORE, M.D.
Summary
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NPI Number |
1942344494 |
| Entity Type Code |
Individual |
| Provider Legal Name |
DR. GEORGE MOORE, M.D. |
| Provider Business Practice Location Address |
11200 GOVERNOR MANLY WAY
STE 205
RALEIGH, NC
ZIP 27614
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| Practice Location Phone Number |
(919) 570-7700 |
| Provider Taxonomy Code |
207Q00000X - Family Medicine |
| Specialization |
|
| Provider Enumeration Date |
2/17/2007 |
| Last Update Date |
6/7/2011 |
NPI Number 1942344494 is assigned to an individual registered under the provider name DR. GEORGE MOORE, M.D. .
The NPPES NPI record indicates the provider is a male.
The provider is physically located at:
11200 GOVERNOR MANLY WAY
STE 205
RALEIGH, NC
ZIP 27614-599
Phone: (919) 570-7700
The enumeration date for this NPI number is 2/17/2007 and was last updated on 6/7/2011 .
Map - Location of Practice
Taxonomy Codes
The following information regarding the scope of practice of this provider is available:
| 1 |
207Q00000X |
Family Medicine |
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26325 |
NC |
View Code |
Other (Legacy) Identifiers
The following legacy identifiers for this provider are available:
| 1 |
8960521 |
MEDICAID |
NC |
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| 2 |
202911D |
MEDICARE PIN |
NC |
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| 3 |
C81559 |
MEDICARE UPIN |
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NPI Record
| 1 |
NPI |
1942344494 |
| 2 |
Entity Type Code |
1 |
| 3 |
Provider Last Name Legal Name |
MOORE |
| 4 |
Provider First Name |
GEORGE |
| 5 |
Provider Name Prefix Text |
DR. |
| 6 |
Provider Credential Text |
M.D. |
| 7 |
Provider First Line Business Practice Location Address |
11200 GOVERNOR MANLY WAY |
| 8 |
Provider Second Line Business Practice Location Address |
STE 205 |
| 9 |
Provider Business Practice Location Address City Name |
RALEIGH |
| 10 |
Provider Business Practice Location Address State Name |
NC |
| 11 |
Provider Business Practice Location Address Postal Code |
276148599 |
| 12 |
Provider Business Practice Location Address Country Code If outside U S |
US |
| 13 |
Provider Business Practice Location Address Telephone Number |
9195707700 |
| 14 |
Provider Enumeration Date |
2/17/2007 |
| 15 |
Last Update Date |
6/7/2011 |
| 16 |
Provider Gender Code |
M |
| 17 |
Healthcare Provider Taxonomy Code 1 |
207Q00000X |
| 18 |
Provider License Number 1 |
26325 |
| 19 |
Provider License Number State Code 1 |
NC |
| 20 |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
| 21 |
Other Provider Identifier 1 |
8960521 |
| 22 |
Other Provider Identifier Type Code 1 |
05 |
| 23 |
Other Provider Identifier State 1 |
NC |
| 24 |
Other Provider Identifier 2 |
202911D |
| 25 |
Other Provider Identifier Type Code 2 |
08 |
| 26 |
Other Provider Identifier State 2 |
NC |
| 27 |
Other Provider Identifier 3 |
C81559 |
| 28 |
Other Provider Identifier Type Code 3 |
02 |
| 29 |
Is Sole Proprietor |
N |
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This page was last updated on: 5/14/2013
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.