MEDICARE: PAULA D MOORE 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
1	207R00000X	Internal Medicine Physician	14740	AL

General Provider Information

NPI Number	:	1952452260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA D MOORE M. D.

Provider Business Mailing Address
First Line	:	2470 ROCKY RIDGE RD
Second Line	:	SUITE 200
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2833
Country	:	US
Telephone Number	:	205-286-3200
Fax Number	:	205-286-3201

Provider Business Practice Location Address
First Line	:	2470 ROCKY RIDGE RD
Second Line	:	SUITE 200
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2833
Country	:	US
Telephone Number	:	205-286-3200
Fax Number	:	205-286-3201

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	01/27/2016

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