Healthcare Provider Details

I. General information

NPI: 1770424939
Provider Name (Legal Business Name): TAYLOR MICHELLE MOORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

IV. Provider business mailing address

1600 ROCKLAND RD
WILMINGTON DE
19803-3607
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC7-0019216
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: