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NPI Code Detail

MEDICARE: STEVEN ANTHONY MOORE MD

MEDICARE:   STEVEN ANTHONY 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
1207Q00000XFamily Medicine Physician2012-01862NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1172848OTHERNCRESIDENT LICENSE NUMBER

General Provider Information

NPI Number : 1336430982
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN ANTHONY MOORE MD
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-384-1260
Fax Number :
Provider Business Practice Location Address
First Line : 9101 MONROE RD
Second Line : SUITE 155
City : CHARLOTTE
State : NC
Zip : 28270-2467
Country : US
Telephone Number : 704-384-1260
Fax Number : 704-384-1289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2011
Last Update Date : 03/07/2023

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Directions to “ STEVEN ANTHONY MOORE MD” Practice Location

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