Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. OTHA MOORE
Active Sole ProprietorMR. OTHA MOORE is a Exclusive Provider Organization healthcare provider located in SOUTHFIELD, Michigan. NPI 1275902132 is currently active in the NPPES registry. Verify at CMS.
Exclusive Provider Organization · SOUTHFIELD, MI
Registration Details
- NPI Number
- 1275902132
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 22, 2015 (10.912641856402 yrs)
- Last Updated
- Sep 22, 2015
- License
-
7153185 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
18430 WESTHAMPTONSOUTHFIELD, MI, 48075Browse MI providers · Browse ZIP 48075
- Phone
- 3138441496
- Primary Specialty
-
Exclusive Provider Organization
302F00000X
Other Exclusive Provider Organization Providers in SOUTHFIELD, MI
| Name | Credential | NPI |
|---|---|---|
| BOSE OGBEIFUN | — | 1417481789 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.