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1902504053 NPI number — SHARMANE DENISE MOORE MD

NPI Number: 1902504053
Health Care Provider/Practitioner: SHARMANE DENISE MOORE MD

Information about “1902504053” NPI (SHARMANE DENISE MOORE MD) exists in 1902504053 in HTML format HTML  |  1902504053 in plain Text format TXT  |  1902504053 in PDF (Portable Document Format) PDF  |  1902504053 in an XML format XML  formats.

NPI Number : 1902504053 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902504053",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOORE",
    "FirstName": "SHARMANE",
    "MiddleName": "DENISE",
    "NamePrefix": "PROF.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "E",
    "OtherFirstName": "ASIA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "PROF.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "266 STATE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW HAVEN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06510-3117",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-204-3584",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "266 STATE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW HAVEN",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06510-3117",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "614-204-3584",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/17/2023",
    "LastUpdateDate": "02/17/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "171000000X",
        "TaxonomyName": "Military Health Care Provider",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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