Provider Demographics
NPI:1447391941
Name:MOORE, MICHAEL B (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8919 PARALLEL PKWY STE 455
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-3628
Mailing Address - Country:US
Mailing Address - Phone:913-596-4929
Mailing Address - Fax:913-596-4982
Practice Address - Street 1:8919 PARALLEL PKWY STE 455
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-3628
Practice Address - Country:US
Practice Address - Phone:913-596-4629
Practice Address - Fax:913-596-4982
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129454207V00000X
KS04-42564207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology