Moore, William David

Moore, William David is an sole proprietor health care provider with primary practice located at 1127 N Western Avenue , Marion IN 46952-1164. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Moore, William David can be contacted via phone (765) 662-4666.

Contact Information

Primary practice address
1127 N Western Avenue Marion IN 46952-1164
Fax: (765) 662-4106
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01043323A Indiana

Profile Details

NPI number 1194801373
LBN Legal business name Moore, William David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2006
Last updated Nov 19th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194801373 NPPES
Indiana MEDICAID 100465860B

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