Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | FM1937739 | MD |
NPI | 1083725303 |
---|---|
Provider Name | Dr. Eva Michele Moore |
First Address | Baltimore, MD 21287-0011 |
Second Address | Baltimore, MD 21287-0011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 20/09/2010 |