Glenn Moore, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

4301041081 Issued in MI

Practice address

40732 Van Dyke Ave.
Sterling Heights, MI 48313-3741

Phone

(615) 778-4066

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239667200000",
    "number": "1669695870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DRIVE",
            "address_2": "SUITE 1200 WEST TOWER",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "800-232-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40732 VAN DYKE AVE.",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483133741",
            "telephone_number": "615-778-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GLENN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MI",
            "license": "4301041081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleaha Faye Montgomery
• Montier Home Health Care,Inc
• Aliya Maria Moody
• Erin Faith Mooney
• Frederick Henry Moore Jr.
• Tina Moore
• Jack Frank Moores III, DDS
• Andrea Morales
• Katelin Moran
• More Than Able Home Care LLC

• Occupational Medicine Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Occupational Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.