Moore, Otha

Moore, Otha is an sole proprietor health care provider with primary practice located at 18430 Westhampton , Southfield MI 48075. He recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as his primary health care specialty. Moore, Otha can be contacted via phone (313) 844-1496.

Contact Information

Primary practice address
18430 Westhampton Southfield MI 48075
Phone: (313) 844-1496
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X 7153185 Michigan

Profile Details

NPI number 1275902132
LBN Legal business name Moore, Otha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2015
Last updated Sep 22nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers