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1659931046
DEREK MOORE
PHILADELPHIA, PA
NPI
1659931046
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: PA MT219038)
Enumeration Date
2019-06-18
Last Update Date
2019-08-01
Business Address
DEREK MOORE
10 SHURS LN STE 301
PHILADELPHIA, PA 19127-2123
Phone number: 215-967-1632
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Mailing Address
DEREK MOORE
10 SHURS LANE SUITE 301
PHILADELPHIA, NJ 19127-2629
Phone number: 215-482-1234
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