Moore, Freeman Mark

Moore, Freeman Mark is an individual health care provider with primary practice located at 225 Memorial Dr , Berlin WI 54923-1243. He recently has only one registered license in Emergency Medical Service Providers / Personal Emergency Response Attendant, which is considered as his primary health care specialty. Moore, Freeman Mark can be contacted via phone (920) 361-1313.

Contact Information

Primary practice address
225 Memorial Dr Berlin WI 54923-1243
Phone: (920) 361-1313
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Personal Emergency Response Attendant 146D00000X 18406 Wisconsin

Profile Details

NPI number 1316973480
LBN Legal business name Moore, Freeman Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316973480 NPPES
Wisconsin MEDICAID 31154500

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