NPI 1376507608

Marla J Moore, MD

Practitioner Pediatric Critical Care Medicine Physician St Cloud, MN

Practice location

Address: 1200 Sixth Ave N Centracare Clinic, St Cloud, MN 56303-2735
Phone: (320) 252-5731
Fax: (719) 447-8987

Registered specialties (4)

Pediatric Critical Care Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2080P0203X Licence 105796 (MN)

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Pediatric Critical Care Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 2080P0203X Licence 36444 (CO)

Pediatric Critical Care Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 2080P0203X Licence CO36444 (CO)

Pediatric Critical Care Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 2080P0203X Licence MD11545 (HI)

Registry record

NPI: 1376507608
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Apr 2006
Record last updated: 27 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.