Moore, Grant K

Moore, Grant K is an individual health care provider with primary practice located at 100 Wason Avenue Suite 100, Springfield MA 01107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Moore, Grant K can be contacted via phone (413) 732-7426.

Contact Information

Primary practice address
100 Wason Avenue Suite 100 Springfield MA 01107
Phone: (413) 732-7426
Fax: (413) 734-2371
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 2372051 New York
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 72182 Massachusetts

Profile Details

NPI number 1528040417
LBN Legal business name Moore, Grant K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Oct 5th, 2009 - about 16 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 1528040417 NPPES
New York MEDICAID 02668239
New York MEDICAID 3065898

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