Healthcare Provider Details

I. General information

NPI: 1659332997
Provider Name (Legal Business Name): RACHEL L MOORE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 11/07/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9950 W 80TH AVE STE 24
ARVADA CO
80005-3914
US

IV. Provider business mailing address

9950 W 80TH AVE STE 24
ARVADA CO
80005-3914
US

V. Phone/Fax

Practice location:
  • Phone: 303-280-0900
  • Fax: 303-280-3858
Mailing address:
  • Phone: 303-280-0900
  • Fax: 303-280-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0069441
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: