Moore, Annette M
Moore, Annette M is an individual health care provider with primary practice located at 3500 S Lafountain St , Kokomo IN 46902-3803. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Moore, Annette M can be contacted via phone (765) 453-8571.Contact Information
Primary practice address
3500 S Lafountain St
Kokomo IN 46902-3803
Phone: (765) 453-8571
Fax: (765) 453-8637
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 01056265A | Indiana |
Profile Details
| NPI number | 1609818467 |
|---|---|
| LBN Legal business name | Moore, Annette M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Nov 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609818467 | NPPES |
| Indiana | Other | P01830736 | RAIL ROAD PTAN |
| Indiana | MEDICAID | 200826150 | RAIL ROAD PTAN |
| Indiana | Other | P01830736 | RAIL ROAD PTAN |
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