Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 0101252879 | VA |
Y | 2084N0400X | Neurologist | 22019 | NC |
N | 2084N0400X | Neurologist | MD066685L | PA |
NPI | 1003195355 |
---|---|
Provider Name | Patricia M Moore |
First Address | Charlotte, NC 28260-0447 |
Second Address | Salisbury, NC 28147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2011 |
Last Update Date | 09/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1830438 | (05) | VA |
B48657 | (02) |