Individual provider · Type 1 NPI
Shelathum Moore
Driver · Fairburn, GA
NPI number
1215647573
Active
Practice location
670 Birkdale Dr
Fairburn, GA 30213-2924
Mailing address
225 Market Place Connector # 1144
Peachtree City, GA 30269-3542
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 050219016 (GA) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
Another provider at this address
Other driver providers in Fairburn
About NPI 1215647573
Shelathum Moore's National Provider Identifier is 1215647573, issued on Nov 28, 2022. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Fairburn, GA. The record was last updated on Nov 28, 2022.