Provider Demographics
NPI:1598755191
Name:MOORES, DUANE P (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:P
Last Name:MOORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2500 STARLING ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4268
Mailing Address - Country:US
Mailing Address - Phone:912-466-5506
Mailing Address - Fax:912-466-5513
Practice Address - Street 1:2500 STARLING ST STE 303
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4268
Practice Address - Country:US
Practice Address - Phone:912-466-5506
Practice Address - Fax:912-466-5513
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA046998207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA774352OtherBCBS
GA00830167AMedicaid
GAG98652Medicare UPIN
GA774352OtherBCBS