Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Michael Thomas Moore, PA-C

Individual provider Physician Assistant · NPI 1346699956

Mr. Michael Thomas Moore, PA-C is a Physician Assistant in Detroit, Michigan. Licensed in Indiana. Registered with an NPI since 2016.

Licensed in
IN
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

22101 Moross Rd
Detroit, MI 48236-2148
Phone: (313) 343-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 10002655A (IN)

Record details

NPI number1346699956
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 6, 2016
Last updated in NPPESMay 12, 2023
Certification dateMay 12, 2023

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