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General NPI Number Information
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NPI Number | 1578527263
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Entity Type | Individual
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Provider Name | EDWARD N MOORE MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 520 MARY ST. SUITE 230
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City | EVANSVILLE
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State | IN
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Zip | 47710-1678
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Country | US
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Telephone | 812-464-9133
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Fax | 812-464-0559
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Provider Business Mailing Address
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Address Line | 4015 GATEWAY BLVD SUITE 2120
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City | NEWBURGH
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State | IN
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Zip | 47630-9460
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Country | US
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Telephone | 812-842-0907
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Fax | 812-464-4485
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01037835A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 26955
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 01037835A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 26955
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License Number State | KY
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