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NPI Code Detail

MEDICARE: DANIEL R. MOORMAN M.D.

MEDICARE: DANIEL R. MOORMAN M.D.
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
12080A0000XPediatric Adolescent Medicine PhysicianMD00047707WA

General Provider Information

NPI Number : 1619932696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL R. MOORMAN M.D.
Provider Business Mailing Address
First Line : 611 N IRON BRIDGE WAY
Second Line :
City : SPOKANE
State : WA
Zip : 99202-4932
Country : US
Telephone Number : 509-444-8888
Fax Number : 509-444-7806
Provider Business Practice Location Address
First Line : 3919 N MAPLE ST
Second Line :
City : SPOKANE
State : WA
Zip : 99205-1349
Country : US
Telephone Number : 509-444-8200
Fax Number : 509-444-7806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 11/29/2021

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