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General NPI Number Information
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NPI Number | 1649298936
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Entity Type | Individual
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Provider Name | DAVID F. MOORE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 4515 PREMIER DR STE 404
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City | HIGH POINT
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State | NC
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Zip | 27265-8356
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Country | US
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Telephone | 336-802-2085
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Fax | 336-802-2086
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Provider Business Mailing Address
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Address Line | 100 KIMEL FOREST DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6074
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Country | US
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Telephone | 336-716-1331
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Fax | 336-716-3202
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 9400588
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License Number State | NC
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