Mary D Moore
Pediatric Rheumatologist
1000 Houghton Ave
Saginaw
, Michigan 48602-5303
Mary D Moore
Pediatric Rheumatologist
1000 Houghton Ave
Saginaw
, Michigan 48602-5303
(989) 746-7752
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About
Features
Specialties
- Pediatric Rheumatologist
Languages spoken
- English
Location
First Address
- Mary D Moore
- 1000 Houghton Ave
- Saginaw, MI
- Zip : 48602-5303
- Fax : (989) 746-7752
- Phone : (989) 746-7500
Second Address
- Mary D Moore
- 1000 Houghton Ave
- Saginaw, MI
- Zip : 48602-5303
- Fax : (989) 746-7752
- Phone : (989) 746-7500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0216X | Pediatric Rheumatologist | 4301080845 | MI |
National Provider Identifier
| NPI | 1275502445 |
|---|---|
| Provider Name | Mary D Moore |
| First Address | Saginaw, MI 48602-5303 |
| Second Address | Saginaw, MI 48602-5303 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/03/2006 |
| Last Update Date | 30/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3503906282 | BCBS (01) | |
| 4440356 | (05) | MI |
| E67807 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.