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1336141258

NPI Code Detail

MEDICARE: RICHARD S. MOORE JR. MD

MEDICARE: RICHARD S. MOORE JR. 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
1	207X00000X	Orthopaedic Surgery Physician	009600648	NC
2	207XS0106X	Orthopaedic Hand Surgery Physician	9600648	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	009600648	OTHER	NC	MEDICAL LICENSE

General Provider Information

NPI Number	:	1336141258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD S. MOORE JR. MD

Provider Business Mailing Address
First Line	:	2716 ASHTON DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2489
Country	:	US
Telephone Number	:	910-763-7344
Fax Number	:	910-251-0421

Provider Business Practice Location Address
First Line	:	2716 ASHTON DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2489
Country	:	US
Telephone Number	:	910-763-7344
Fax Number	:	910-251-0421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	09/23/2021

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Directions to “ RICHARD S. MOORE JR. MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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