Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 200500468 | NC |
NPI | 1063473049 |
---|---|
Provider Name | Robert B Moore |
First Address | Asheville, NC 28803 |
Second Address | Asheville, NC 28803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5900808 | (05) | NC |
D73534 | (02) |