Moore, Derek Ronald
Moore, Derek Ronald is an individual health care provider with primary practice located at 655 Jesse Jewell Pkwy Se Ste B, Gainesville GA 30501-3854. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Moore, Derek Ronald can be contacted via phone (770) 532-7092.Contact Information
Primary practice address
655 Jesse Jewell Pkwy Se Ste B
Gainesville GA 30501-3854
Phone: (770) 532-7092
Fax: (770) 536-0383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 054090 | Georgia |
Profile Details
| NPI number | 1871516930 |
|---|---|
| LBN Legal business name | Moore, Derek Ronald |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Aug 15th, 2011 - about 14 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 | 1871516930 | NPPES |
| Georgia | Other | 0901538 | UHC |
| Georgia | Other | 10062471 | UHC |
| Georgia | MEDICAID | 203604041D | UHC |
| Georgia | Other | 7851732 | UHC |
| Georgia | Other | 52703247 | UHC |
| Georgia | MEDICAID | 203604041C | UHC |
| Georgia | Other | 4599810 | UHC |
| Georgia | Other | P00349858 | UHC |
| Georgia | Other | 342650 | UHC |
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