Provider Demographics
NPI:1093455495
Name:MOORE, DANIEL ANDREW
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANDREW
Last Name:MOORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APPFAMILY MEDICINE 148 NC-105 EXTENSION
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:26807-6529
Mailing Address - Country:US
Mailing Address - Phone:828-262-4100
Mailing Address - Fax:
Practice Address - Street 1:APPFAMILY MEDICINE 148 NC-105 EXTENSION
Practice Address - Street 2:SUITE 102
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:26807
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program