Provider Demographics
NPI:1346602406
Name:MOORE, JUSTIN MURRAY (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MURRAY
Last Name:MOORE
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:101 S. HUNTINGTON AVENUE
Mailing Address - Street 2:APT #1605
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 FRANCIS ST
Practice Address - Street 2:LOWRY BUILDING, SUITE 3B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-632-7246
Practice Address - Fax:617-632-0949
Is Sole Proprietor?:No
Enumeration Date:2016-03-27
Last Update Date:2019-02-20
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Provider Licenses
StateLicense IDTaxonomies
MA273410207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery