Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bryan Russell Moore, PAA

Individual provider Physician Assistant · NPI 1356388433

Bryan Russell Moore, PAA is an Anesthesiology Assistant in Marietta, Georgia. Graduated from Emory University School of Medicine in 2002, 24 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group and works from 2 locations. Licensed in Georgia.

Years since qualifying
24
Trained at
Emory University School of Medicine
Licensed in
GA
In the registry since
2006
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Practice location Address checks out

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone: (470) 644-1274
Fax: (470) 644-1119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501 Redmond Rd Nw, Rome, GA 30165-1415 — (706) 291-0291

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 003912 (GA)

Record details

NPI number1356388433
Entity typeIndividual (Type 1)
GenderMale
Credentials PAA
Sole proprietorYes
NPI enumeratedMay 31, 2006
Last updated in NPPESOctober 10, 2023
Certification dateOctober 10, 2023
Mailing address2540 Windy Hill Rd Se, Marietta, GA 30067-8605

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Not indicated
Practice locations7 on file with Medicare

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