Provider Demographics
NPI:1952445843
Name:MOOR, M EUGENE III (MD)
Entity Type:Individual
Prefix:DR
First Name:M
Middle Name:EUGENE
Last Name:MOOR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 382557
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35238
Mailing Address - Country:US
Mailing Address - Phone:205-871-2002
Mailing Address - Fax:
Practice Address - Street 1:2850 CAHABA RD
Practice Address - Street 2:STE 120
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213
Practice Address - Country:US
Practice Address - Phone:205-871-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9986208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL19981OtherBCBS
C78993Medicare UPIN
AL000019981Medicare PIN