DR. COURTNEY MAGDALENE MOORE (NPI# 1154734812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154734812 |
| Entity Type | Individual |
| Full Name | DR. COURTNEY MAGDALENE MOORE |
| Credential | M.D. |
| Practice Address |
22250 Providence Dr Ste 301 Southfield MI 48075-6211 |
| Practice Telephone | 2488493281 |
| Practice Fax Number | 2488495449 |
| Mailing Telephone | 2488493281 |
| Mailing Fax Number | 2488495449 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2018-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301105763 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4201 Saint Antoine St, 2e, Detroit, MI 482012153 | 3137457999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952832677 | Courtney Moore | Behavior Technician | 1675 Sw Marlow Ave Ste 204, Portland, OR 97225-5102 | 2017-03-23 |
| 1306290333 | Courtney Michelle Moore | Student in an Organized Health Care Education/Training Program | 3852 W 370 Rd, Adair, OK 74330-2792 | 2016-04-15 |
| 1639543887 | Courtney King Moore | Counselor | 650 Henderson Dr Ste 432, Cartersville, GA 30120-3760 | 2015-11-25 |
| 1093068306 | Courtney Rose Moore | Behavioral Analyst | 14131 Midway Rd Ste 800, Addison, TX 75001-3627 | 2012-10-24 |
| 1538499157 | Courtney Keese Moore | Acupuncturist | 605 Chenery Street, Suite C, San Francisco, CA 94131-2956 | 2010-01-04 |
| 1316194053 | Courtney Savannah Moore | Counselor | 45 Olguin Rd, Jarales, NM 87023-9703 | 2008-08-25 |
| 1205030004 | Courtney Claude Moore | Pharmacist | 1864 Union St, Clearwater, FL 33763-2246 | 2007-06-14 |
| 1962548925 | Courtney Joseph Moore | Physical Therapist | 2251 Country Club Lane, Selma, CA 93662 | 2007-01-29 |
| 1043810922 | Courtney Moore | Pharmacist | 262 Cordele Rd, Albany, GA 31705-2407 | 2020-10-29 |
| 1689274169 | Courtney L Moore | Behavior Technician | 1800 Nw 169th Pl Ste B100, Beaverton, OR 97006-7362 | 2020-10-26 |
| Street Address |
22250 PROVIDENCE DR STE 301 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-6211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164047932 | Ammar Wadi Alkhafaji | Internal Medicine | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2020-06-08 |
| 1437774213 | Patrick Michael Lazarczyk | Internal Medicine | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2020-06-08 |
| 1518511179 | Andrew Bacha | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2019-07-31 |
| 1669024915 | Jacob Alex | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2019-07-16 |
| 1699330829 | Ahmad Rachid | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2019-05-02 |
| 1982269254 | Neam Alazawi | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2019-05-02 |
| 1437612579 | Salam Brikho | Student in an Organized Health Care Education/Training Program | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2019-04-06 |
| 1689129702 | Jeremy Reid Heffernan | Internal Medicine | 22250 Providence Dr Ste 301, Southfield, MI 48075-6211 | 2016-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1063036960 | Hawra Kamal | Internal Medicine | Academic Internal Medicine 22250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1578187175 | Brittni Mcclellan | Internal Medicine | 16001 W 9 Mile Rd # Rs, Southfield, MI 48075-4818 | 2020-05-31 |
| 1841811882 | Humza Medical Md PC | Internal Medicine | 27207 Lahser Suite 200b, Southfield, MI 48034-8407 | 2020-04-30 |
| 1487168001 | Us Knee Center Pllc | Internal Medicine | 24901 Northwestern Hwy Ste 113, Southfield, MI 48075-2200 | 2017-11-17 |
| 1427576636 | Comfort Care Center Corp | Internal Medicine | 15565 Northland Dr E Ste 204, Southfield, MI 48075 | 2017-09-07 |
| 1609391382 | Excellence Home Physicians | Internal Medicine | 16910 W 10 Mile Rd Ste 105, Southfield, MI 48075-2900 | 2017-08-03 |
| 1598112567 | Ark Multispecialty Physicians Pllc | Internal Medicine | 25130 Southfield Rd, Suite 230, Southfield, MI 48075-1910 | 2016-05-19 |
| 1659756005 | Haseeb Aslam | Internal Medicine | 16001 West Nile Mile Road Fisher Center, 401, Southfield, MI 48075 | 2015-07-28 |
| 1548643562 | Erin Goldman | Internal Medicine | 16001 W Nine Mile Road, Providence Hospital Medical Ctr. Grad Med Education, Southfield, MI 48075 | 2015-07-08 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on DR. COURTNEY MAGDALENE MOORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.