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Dr. Nicholas Vencenzo Moore, DO
Student in an Organized Health Care Education/Training Program in Warren, Michigan
NPI 1104492529

Nicholas Vencenzo Moore is a Student in an Organized Health Care Education/Training Program based in Sterling Heights, MI. Nicholas Vencenzo Moore practices in Warren, MI and has the professional credentials of DO. The NPI Number for Nicholas Vencenzo Moore is 1104492529 and holds a License No. (Michigan).

The current practice location address for Nicholas Vencenzo Moore is 11885 E 12 Mile Rd Ste 300A, Warren, MI and can be reached out via phone at 586-852-6630.

Location: 11885 E 12 Mile Rd Ste 300A, Warren, MI, 48314-2070
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104492529
Provider Name
Nicholas Vencenzo Moore
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
11885 E 12 Mile Rd Ste 300A, Warren, MI, 48314-2070
Phone Number
586-852-6630
Fax Number
Provider Enumeration Date
05/27/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11885 E 12 Mile Rd Ste 300A
City
Warren
State
Michigan
Zip
48093-3467
Phone Number
586-852-6630
Fax Number
person
Provider Business Mailing Address Details
Address
11885 E 12 Mile Rd Ste 300A
City
Warren
State
Michigan
Zip
48093-3467
Phone Number
586-852-6630
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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