Individual provider · Type 1 NPI

Elliott Matthew Moore

Student in an Organized Health Care Education/Training Program · Augusta, GA

NPI number 1912851007 Active

Practice location

1120 15th St # GC5114
Augusta, GA 30912-0004

Call (706) 721-2411 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XDN124199 (GA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912851007

Elliott Matthew Moore's National Provider Identifier is 1912851007, issued on Feb 24, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Augusta, GA. The record was last updated on Jul 10, 2026.