Individual provider · Type 1 NPI
Michael Moore, CCP
Specialist · Phoenix, AZ
NPI number
1659409092
Active
Practice location
10930 N Tatum Blvd, #103
Phoenix, AZ 85028-6069
Fax (602) 212-0365
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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- Frank Bernard Simchak, MDSpecialist Phoenix, AZ NPI 1033199781
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About NPI 1659409092
Michael Moore, CCP's National Provider Identifier is 1659409092, issued on Feb 28, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 8, 2007.