| Matthew D Moore Llc | |
|
2141 North Fairfield Road Suite C Beavercreek OH 45431-2579 | |
| (937) 429-9683 | |
| (937) 429-9729 |
| Full Name | Matthew D Moore Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2141 North Fairfield Road, Beavercreek, Ohio |
| Authorized Official Name and Position | Matthew D Moore (OWNER) |
| Authorized Official Contact | 9374299683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew D Moore Llc 2141 North Fairfield Road Suite C Beavercreek OH 45431-2579 Ph: (937) 429-9683 | Matthew D Moore Llc 2141 North Fairfield Road Suite C Beavercreek OH 45431-2579 Ph: (937) 429-9683 |
| NPI Number | 1760661367 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 10/31/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760661367 | NPI | - | NPPES |
| 000000281392 | Other | OH | ANTHEM |
| 0671983 | Medicaid | OH | |
| 2060101 | Other | OH | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35055799M (Ohio) | Primary |
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