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NPI Code Detail

MEDICARE: DR. DANIEL P MOORE MD

MEDICARE: DR. DANIEL P MOORE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician9501014NC
2208100000XPhysical Medicine & Rehabilitation Physician0101051306VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1250007944OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
260394OTHERNCBCBS NC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134113335
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL P MOORE MD
Provider Business Mailing Address
First Line : 2331 FRANKLIN RD SW
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1111
Country : US
Telephone Number : 540-224-5170
Fax Number : 540-857-5306
Provider Business Practice Location Address
First Line : 2331 FRANKLIN RD SW
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1111
Country : US
Telephone Number : 540-224-5170
Fax Number : 540-857-5306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 02/22/2024

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Directions to “ DR. DANIEL P MOORE MD” Practice Location

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