Healthcare Provider Details

I. General information

NPI: 1316669518
Provider Name (Legal Business Name): MORE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 SYCAMORE LN
MADISON MS
39110-7445
US

IV. Provider business mailing address

9204 W FOOTHILL DR
PEORIA AZ
85383-4158
US

V. Phone/Fax

Practice location:
  • Phone: 623-363-0644
  • Fax: 480-378-3537
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: RAGHAV MOHINDRA
Title or Position: OWNER
Credential: MD
Phone: 623-363-0644