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

Matthew Benjamin Moore, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1013767193

Matthew Benjamin Moore, MD is a Student in an Organized Health Care Education/Training Program in Macon, Georgia. Licensed in Georgia. Registered with an NPI since 2024.

Licensed in
GA
In the registry since
2024
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

777 Hemlock Street Ln # 165
Macon, GA 31201-2168
Phone: (478) 633-1634
Fax: (478) 633-1578
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 16001 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1013767193
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2024
Last updated in NPPESJune 14, 2024
Certification dateJune 14, 2024
Mailing address777 Hemlock Street Ln # 165, Macon, GA 31201-2168

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