Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 0101238019 | VA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 2008-01055 | NC |
NPI | 1013065200 |
---|---|
Provider Name | Dr. Eric Stephen Moore |
First Address | Durham, NC 27713-4430 |
Second Address | Durham, NC 27705-2659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2007 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5910553 | (05) | NC |