Moore, Michael J
Moore, Michael J is an sole proprietor health care provider with primary practice located at 131 Ornac John Cummings Bldg, Concord MA 01742-4181. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Moore, Michael J can be contacted via phone (781) 259-0803.Contact Information
Primary practice address
131 Ornac John Cummings Bldg
Concord MA 01742-4181
Phone: (781) 259-0803
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 29410 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 29410 | Massachusetts |
Profile Details
| NPI number | 1689655151 |
|---|---|
| LBN Legal business name | Moore, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Sep 27th, 2012 - about 12 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 | 1689655151 | NPPES |
| Massachusetts | Other | B23053 | BCBS |
| Massachusetts | Other | 029410 | BCBS |
| Massachusetts | Other | 11461 | BCBS |
| Massachusetts | Other | 000000024368 | BCBS |
| Massachusetts | MEDICAID | 3196640 | BCBS |
| Massachusetts | Other | 05-04349 | BCBS |
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