Provider Demographics
NPI:1134012719
Name:RICHARD A MOORE MD INTERNAL MEDICINE LLC
Entity type:Organization
Organization Name:RICHARD A MOORE MD INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-733-7672
Mailing Address - Street 1:148 W RIVER ST STE 22B
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2628
Mailing Address - Country:US
Mailing Address - Phone:401-572-3887
Mailing Address - Fax:401-865-6192
Practice Address - Street 1:148 W RIVER ST STE 22B
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2628
Practice Address - Country:US
Practice Address - Phone:401-572-3887
Practice Address - Fax:401-865-6192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty