MICHAEL T MOORE MD NPI 1629053707

NPI Information

  • NPI: 1629053707
  • Provider Name: MICHAEL T MOORE, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 1008 N WASHINGTON ST
    NEVADA, MO
    ZIP 64772
  • Phone: (417) 667-3919

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NPI Details

Michael T Moore, MD is a diagnostic radiology radiology in Nevada, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Michael T Moore, MD NPI is 1629053707. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1008 N WASHINGTON ST
NEVADA, MO
ZIP 64772-463
Phone: (417) 667-3919

The enumeration date for this NPI number is 12/12/2005 and was last updated on 11/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyR7354MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200214005MEDICAIDMISSOURI
2C52092MEDICARE UPINMISSOURI
30003560MEDICARE ID-TYPE UNSPECIFIEDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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