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Contact Information

SUE D MOORE, MD
621 S NEW BALLAS RD
SUITE 2009B
SAINT LOUIS, MO63141-8232
 Phone: 314-251-6880
 Fax: 314-251-6919
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for SUE D MOORE · (Female)

NPI # 1164459772
Status Active
Credentials MD
Entity Individual
Enumeration date 06/27/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 113681
  • MO Other 4454848 AETNA
  • MO Other 113282 BLUE CROSS BLUE SHIELD
  • MO Other 6715780 CIGNA
  • MO Other 272132 GROUP HEALTHPLAN
  • MO Other 338322 HEALTHLINK
  • MO Other 7400110 UNITED HEALTHCARE
Hospital affiliation(s)
  • MERCY HOSPITAL ST LOUIS - (Acute Care)
    615 NEW BALLAS ROAD
    SAINT LOUIS, MO 63141
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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