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General NPI Number Information
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NPI Number | 1619741527
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Entity Type | Individual
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Provider Name | CAMREN CHRISTOPHER LEE MOORE PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 3535 OLENTANGY RIVER RD
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City | COLUMBUS
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State | OH
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Zip | 43214-3908
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Country | US
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Telephone | 614-566-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3525 OLENTANGY RIVER RD STE 5320
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City | COLUMBUS
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State | OH
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Zip | 43214-3937
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Country | US
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Telephone |
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Fax |
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 50.008580RX
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 50.008580RX
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License Number State | OH
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