Individual
DR. KEVIN DALE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 GARRISONVILLE RD, 109, STAFFORD, VA 22554
(703) 522-2727
(540) 288-3327
Mailing address
34 MONUMENT DR, STAFFORD, VA 22554-8508
(571) 409-0161
(540) 288-3327
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
28200
KY
2084P0800X
Psychiatry Physician
Primary
0101255019
VA
2084P0800X
Psychiatry Physician
2014-01019
NC
2084P0800X
Psychiatry Physician
28200
KY
2084P0802X
Addiction Psychiatry Physician
28200
KY
Other
Enumeration date
01/09/2006
Last updated
01/23/2026
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