Provider Demographics
NPI:1588975296
Name:MOORE, BRADLEY ALLEN JR (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:ALLEN
Last Name:MOORE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:168 E MARKET ST
Mailing Address - Street 2:PO BOX 3542
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-2038
Mailing Address - Country:US
Mailing Address - Phone:330-996-8603
Mailing Address - Fax:330-996-0359
Practice Address - Street 1:55 ARCH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1423
Practice Address - Country:US
Practice Address - Phone:330-375-3315
Practice Address - Fax:330-375-3760
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2013-07-02
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Provider Licenses
StateLicense IDTaxonomies
OH35120868207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine