Andrew Marc Moore

Physician Assistant · Beavercreek, OH

Individual Active NPI

NPI number 1710462734

Practice location

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone
(937) 702-4024
Fax
(937) 702-4035

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NPI record

NPI
1710462734
Entity type
Individual (Type 1)
Enumeration date
September 25, 2018
Last updated
January 12, 2021
Certified
January 12, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 50.005821RX OH
Medical Physician Assistant 363AM0700X 3688 TN

Mailing address

2105 Sherbrooke Ln
Nashville, TN 37211-7029
Phone
(865) 776-8490

Other practice locations (1)

  • 2105 Sherbrooke Ln, Nashville, TN 37211-7029 · (865) 776-8490

About Andrew Moore

Andrew Marc Moore is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 3535 Pentagon Blvd, Beavercreek, OH 45431-1705. The NPI number 1710462734 was assigned on September 25, 2018 and the record was last updated on January 12, 2021.

Andrew Moore lists 2 licenses in the registry: #50.005821RX (OH) for Physician Assistant; #3688 (TN) for Medical Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Andrew Marc Moore?

The NPI number is 1710462734.

What is the phone number of Andrew Moore?

The phone number listed for the practice location is (937) 702-4024.

Where is Andrew Moore located?

3535 Pentagon Blvd, Beavercreek, OH 45431-1705.

What is the taxonomy code for Andrew Moore?

The primary taxonomy code is 363A00000X – Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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