IndividualActive
Timothy Moore, MD
NPI 1124064423 · Cardiovascular Disease Physician · Boise, ID
Provider details
- NPI number
- 1124064423
- Entity type
- Individual
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- M-12911 (ID)
Practice location
500 W. Fort St.
#111
Boise, ID 83702
Phone: (208) 422-1000
Fax: (208) 422-1319
Mailing address
500 W Fort St # 111
Boise, ID 83702-4501
Registry dates
- Enumerated
- 2006-06-22
- Last updated
- 2022-02-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.