Moore, Wistar

Moore, Wistar is an individual health care provider with primary practice located at 801 E 6Th St Ste 307 , Panama City FL 32401-3663. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Moore, Wistar can be contacted via phone (850) 785-9559.

Contact Information

Primary practice address
801 E 6Th St Ste 307 Panama City FL 32401-3663
Phone: (850) 785-9559
Fax: (850) 608-6423
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X ME64685 Florida

Profile Details

NPI number 1326076274
LBN Legal business name Moore, Wistar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Mar 1st, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326076274 NPPES
Florida MEDICAID 375218600

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