Moore, James Robert

Moore, James Robert is an individual health care provider with primary practice located at 2545 Chicago Ave #512, Minneapolis MN 55404-4522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Moore, James Robert can be contacted via phone (612) 813-6475.

Contact Information

Primary practice address
2545 Chicago Ave #512 Minneapolis MN 55404-4522
Phone: (612) 813-6475
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 23272 Minnesota

Profile Details

NPI number 1275624561
LBN Legal business name Moore, James Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Jul 8th, 2007 - about 17 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 1275624561 NPPES
Minnesota MEDICAID 056300500

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