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NPI Code Detail

MEDICARE: SHELLEY W. MOORE MD

MEDICARE: SHELLEY W. MOORE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine Physician54549CO

General Provider Information

NPI Number : 1144275215
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY W. MOORE MD
Provider Business Mailing Address
First Line : 3519 RICHMOND DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5995
Country : US
Telephone Number : 970-449-0951
Fax Number : 970-823-9004
Provider Business Practice Location Address
First Line : 3519 RICHMOND DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5995
Country : US
Telephone Number : 970-204-0300
Fax Number : 970-221-5206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 11/12/2025

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Directions to “ SHELLEY W. MOORE MD” Practice Location

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