Individual
JEFFREY P. MOAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2978
(202) 884-2020
Mailing address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2978
(202) 884-2020
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
MD19244
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160
CAREFIRST
DC
05
—
0279559900
—
DC
05
—
6724591
—
VA
Enumeration date
10/02/2006
Last updated
07/09/2007
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