NPI 1750800058

Shawn Anthony Moore

Practitioner Intermediate Emergency Medical Technician Stone Mountain, GA

Practice location

Address: 900 N Hairston Rd STE A3, Stone Mountain, GA 30083-2857
Phone: (678) 902-4947
Mailing address: 1921 Brook View Ave, Doraville, GA 30340-3850

Registered specialties

Intermediate Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146M00000X Licence 00243250 (GA)

Other Emergency Medical Technician, Intermediate providers in Georgia →

Registry record

NPI: 1750800058
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Sep 2017
Record last updated: 17 Mar 2018

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.