Nicholas Jay Moore
Family Doctor Family Doctor - Sports Medicine
26850 Providence Pkwy Ste 260
Novi
, Michigan 48374-1256
Nicholas Jay Moore
Family Doctor Family Doctor - Sports Medicine
26850 Providence Pkwy Ste 260
Novi
, Michigan 48374-1256
(248) 465-5141
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Nicholas Jay Moore
- 26850 Providence Pkwy Ste 260
- Novi, MI
- Zip : 48374-1256
- Fax : (248) 465-5141
- Phone : (248) 465-5140
Second Address
- Nicholas Jay Moore
- 26850 Providence Pkwy Ste 260
- Novi, MI
- Zip : 48374-1256
- Fax : (248) 465-5141
- Phone : (248) 465-5140
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 4301108292 | MI |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 4301108292 | MI |
National Provider Identifier
| NPI | 1265727556 |
|---|---|
| Provider Name | Nicholas Jay Moore |
| First Address | Novi, MI 48374-1256 |
| Second Address | Novi, MI 48374-1256 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/06/2011 |
| Last Update Date | 16/04/2019 |
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.