Healthcare Provider Details

I. General information

NPI: 1790148948
Provider Name (Legal Business Name): CHRISTINE ANN MOORE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL PARK DR STE B
ASHEVILLE NC
28803-2493
US

IV. Provider business mailing address

PO BOX 1869
FLETCHER NC
28732-1869
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-8232
  • Fax: 828-253-4470
Mailing address:
  • Phone: 828-687-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2022-00763
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: