IndividualActive
Douglas Moore, D.O.
NPI 1194729053 · Clinical Cardiac Electrophysiology Physician · Roseville, MI
Provider details
- NPI number
- 1194729053
- Entity type
- Individual
- Primary specialty
- Clinical Cardiac Electrophysiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- 0102202087 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
25195 Kelly Rd Ste a
Roseville, MI 48066-4909
Phone: (586) 775-4594
Fax: (586) 775-4506
Approximate (ZIP-level) locationGet directions
Mailing address
25195 Kelly Rd Ste a
Roseville, MI 48066-4909
Additional practice locations (2)
- 310 Lafayette Ave Se Ste 300Grand Rapids, MI 49503-4693Phone: (616) 685-3450Fax: (616) 685-3454
- 1223 Mercy DrMuskegon, MI 49444-1829Phone: (231) 672-3500Fax: (231) 672-6199
Registry dates
- Enumerated
- 2005-06-09
- Last updated
- 2024-10-11
- Certified
- 2024-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.