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NPI Code Detail

MEDICARE: MICHAEL MOORE DO

MEDICARE: MICHAEL MOORE DO
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
1204D00000XNeuromusculoskeletal Medicine & OMM Physician6517718-1204UT

General Provider Information

NPI Number : 1144638008
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MOORE DO
Provider Business Mailing Address
First Line : 2121 N 1700 W
Second Line :
City : LAYTON
State : UT
Zip : 84041-8803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2121 N 1700 W
Second Line :
City : LAYTON
State : UT
Zip : 84041-8803
Country : US
Telephone Number : 801-773-4840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2014
Last Update Date : 01/12/2026

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Directions to “ MICHAEL MOORE DO” Practice Location

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