DR. GLENNDALE MOORE


Address: 2949 New Bern Ave, Suite 112-a, Raleigh, NC 27610-1248
Phone: 9192313614

DR. GLENNDALE MOORE (NPI# 1164485033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164485033
Entity Type Individual
Full Name DR. GLENNDALE MOORE
Credential M.D.
Practice Address 2949 New Bern Ave
Suite 112-a
Raleigh
NC 27610-1248
Mailing Address Po Box 28510
Raleigh
NC 27611-8510
Practice Telephone 9192313614
Practice Fax Number 9192129029
Mailing Telephone 9192313614
Mailing Fax Number 9192129029
Enumeration Date 2006-04-10
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
24609 NC Allopathic & Osteopathic Physicians

Office Location

Street Address 2949 NEW BERN AVE
SUITE 112-A
City RALEIGH
State NC
Zip Code 27610-1248

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1629341607 1st Opportunity Behavioral Health Counselor 2949 New Bern Ave, Suite 110-b, Raleigh, NC 27610-1248 2012-02-21
1548530751 Solution Focused Services, LLC Counselor 2949 New Bern Ave, Suite 110-b, Raleigh, NC 27610-1248 2012-01-04
1265717326 Alice Valencia Nunn Counselor 2949 New Bern Ave, Suite110-b, Raleigh, NC 27610-1248 2011-10-19
1578899175 One Village One World Enhanced Services, LLC Community/Behavioral Health 2949 New Bern Ave, Suite 110, Raleigh, NC 27610-1248 2009-11-02
1316113962 Dr. Betty K. Sutton Clinic/Center 2949 New Bern Ave, Suite 109a, Raleigh, NC 27610-1248 2008-05-05
1851576789 Ladonna M Clark Counselor 2949 New Bern Ave, Suite 109, Raleigh, NC 27610-1248 2008-01-09
1639371925 Carl Kent Speller Sr. Counselor 2949 New Bern Ave, Suite 107a, Raleigh, NC 27610-1248 2007-05-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1609499243 Elizabeth Ranganai Mavindidze Social Worker Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 2020-05-18
1851958839 Alex & Associates, P.C. Dentist 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 2019-05-24
1639646367 Carol Mary Medins Dietitian, Registered Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 2018-10-31
1144714601 Walgreen Co Durable Medical Equipment & Medical Supplies 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 2018-06-19
1417446006 Eagles Eye Lab, Inc Clinical Medical Laboratory 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 2018-05-09
1316465206 Jeffery King Neer Social Worker 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 2017-08-31
1083139885 Kelsey Daniel Mccleave Social Worker 3630 Enduring Freedom Drive, Raleigh, NC 27610 2017-08-14
1891219093 Tarheel Residential Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4840 Quarryman Road, Raleigh, NC 27610 2017-07-29
1508214826 Compassionate Care Providers LLC Respite Care 5110 Wetlands, Raleigh, NC 27610 2016-05-26
1730552530 Matthew Belair Pharmacist 1601-51 Cross Link Rd, Raleigh, NC 27610 2015-11-03
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841713187 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave Ste 1200, Raleigh, NC 27610-1231 2017-07-19
1407919285 Angelo Milazzo Internal Medicine 3713 Benson Dr Ste 202, Raleigh, NC 27609-7372 2006-12-19
1639253529 James Wilson Peterson Internal Medicine 3320 Wake Forest Rd., Suite 200, Raleigh, NC 27609 2006-10-25
1821010067 Walter Tan Internal Medicine 3000 New Bern Ave Ste 1100, Wpp - Structural Heart, Raleigh, NC 27610-1231 2006-07-24
1881680098 Joseph Anthony Guzzo Internal Medicine 4201 Lake Boone Trl, Suite 104, Raleigh, NC 27607-7512 2005-09-22
1972508661 George Rayburn Cheely Internal Medicine 3000 New Bern Ave, Ste 1200, Raleigh, NC 27610-1231 2005-06-17
1245235506 Sagir Ahmed Internal Medicine 3811 Ed Dr, Suite 130, Raleigh, NC 27612-2392 2005-06-14
1104480532 Wakemed Specialists Group, LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2019-05-01
1720643174 Wakemed Specialists Group, LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2019-05-01
1154713550 Wake Specialty Physicians LLC Internal Medicine 3000 New Bern Ave, Raleigh, NC 27610-1231 2015-02-23
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Competitor

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City RALEIGH
Zip Code 27610

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Dataset Information

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.

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