# MARYANN D. MOORE, MDPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639363559
- **Authorized official:** DR. MARY ANN MOORE M.D. (OWNER)
- **Authorized official phone:** (410) 228-2603

## Contact information

- **Practice address:** 300 DORCHESTER AVE, CAMBRIDGE, MD 21613-2420
- **Practice address phone:** (410) 228-2603
- **Practice address fax:** (410) 901-6080
- **Mailing address:** 300 DORCHESTER AVE, CAMBRIDGE, MD 21613-2420
- **Mailing address phone:** (410) 228-2603
- **Mailing address fax:** (410) 901-6080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | C0000549 | MD | — |
| 207R00000X | Internal Medicine Physician | D0031766 | MD | Yes |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 08/06/2010