DR. DOUGLAS R MOORE (NPI# 1194729053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194729053 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS R MOORE |
| Credential | D.O. |
| Practice Address |
25195 Kelly Rd Ste A Roseville MI 48066-4909 |
| Practice Telephone | 5867754594 |
| Practice Fax Number | 5867754506 |
| Mailing Telephone | 5867754594 |
| Mailing Fax Number | 5867754506 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
0102202087 | VA | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
5101013212 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
0102202087 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669710364 | Douglas Brian Moore | Physical Therapist | 18305 Lyles Dr, Hagerstown, MD 21740-9517 | 2013-01-30 |
| 1528206950 | Douglas Robert Moore | Hearing Instrument Specialist | 14840 Military Trl, Delray Beach, FL 33484-8153 | 2009-01-22 |
| 1578621363 | Douglas William Moore | Dentist | 1011 A Ave W, Oskaloosa, IA 52577-0228 | 2006-12-05 |
| 1679574396 | Douglas Loran Moore | Optometrist | 1902 W 19th St, Suite A, Mountain Grove, MO 65711-1287 | 2005-08-03 |
| 1760008460 | Douglas G Moore | Counselor | 1801 Cherry Hill Rd, Baltimore, MD 21230-3503 | 2020-06-19 |
| 1396064804 | Douglas Boylston Moore IIi | Family Medicine | 901 W Greenwood St, Suite 9, Abbeville, SC 29620-5717 | 2010-05-24 |
| 1427280155 | Douglas John Moore | Psychologist | 6611 Rockside Rd, Suite 215, Independence, OH 44131-2365 | 2009-08-13 |
| 1265696876 | Douglas Richard Moore | Internal Medicine | 7710 Mercy Rd Ste 3000, Omaha, NE 68124-2350 | 2008-07-12 |
| 1417121492 | Douglas William Moore | Obstetrics & Gynecology | 1230 E 6th Ave, Suite 2b, Winfield, KS 67156-3143 | 2008-04-21 |
| 1790853422 | Douglas Bernard Moore | Physician Assistant | 1304 Fawcett Ave, Suite 100, Tacoma, WA 98402-1911 | 2006-12-01 |
| Street Address |
25195 KELLY RD STE A |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-4909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811424245 | Eastside Cardiovascular Medicine | Internal Medicine | 25195 Kelly Rd Ste A, Roseville, MI 48066-4909 | 2017-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154350890 | Cardiovascular Institute of Michigan, P.C. | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639788367 | Tsz Kin Tam | Internal Medicine | 1500 E Medical Center Dr Spc 5869, Ann Arbor, MI 48109-5869 | 2020-07-29 |
| 1861804023 | Ashish Gangasani Md Pllc | Internal Medicine | 6881 Brook Hollow Ct, West Bloomfield, MI 48322-5208 | 2014-05-22 |
| 1245675792 | West Michigan Heart | Internal Medicine | 705 Oak St Unit 1, Big Rapids, MI 49307-3109 | 2013-05-09 |
| 1093941395 | Firas Zahwe | Internal Medicine | 4900 Mercury Dr Ste 202, Dearborn, MI 48126-2947 | 2009-06-02 |
| 1215145420 | Hossam Eldin Imam Mustafa | Internal Medicine | 900 Cooper Ave Ste 4100, Saginaw, MI 48602 | 2007-05-19 |
| 1063588382 | Arrhythmia Center of Southwest Michigan | Internal Medicine | 7901 12th Street, Suite 201, Portage, MI 49024 | 2006-11-28 |
| 1609838804 | Francis A Grubelich | Internal Medicine | 7901 12th St, Ste 201, Portage, MI 49024 | 2006-04-04 |
| 1639725252 | Yuet Wong Cheng | Internal Medicine | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2019-08-11 |
| 1629537147 | Michigan Heart Rhythm Center Pllc | Internal Medicine | 4900 Mercury Dr Ste 202, Dearborn, MI 48126-2947 | 2019-03-14 |
| 1679030530 | Heart and Vascular Institute | Internal Medicine | 22720 Michigan Ave Ste 200, Dearborn, MI 48124-2021 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.