Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21690 | NC |
N | 111NI0900X | Internist | 21690 | NC |
Y | 207RH0003X | Hematology & Oncology | 21690 | NC |
NPI | 1043373822 |
---|---|
Provider Name | Joseph Moore |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27710-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 14/11/2007 |