| Doctor Name: | MICHAEL J MOORE |
| NPI Number: | 1073562476 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 10112 |
| Business Practice Address: | 5151 E. Hwy 90 Sierra Vista, AZ - 85635 |
| Business Phone Number: | 5208036644 |
| Business Fax Number: | 5205442943 |
| Mailing Address: | 5151 E. Hwy 90, SIERRA VISTA |
| State: | AZ |
| Postal Code: | 85635 |
| Phone Number: | 5205197720 |
| Fax Number: | 5205195181 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 03/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0203X |
| License Number: | 10112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Therapeutic Radiology |
| Taxonomy Definition: | |