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Individual

ROBERTA MAUREEN MORELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
19415 DEERFIELD AVE, SUITE 314, LEESBURG, VA 20176-8452
(703) 723-7171
(703) 723-7176
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 723-7171
(703) 723-7176

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101049184
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0700014603
RR MEDICARE
05
1104819739
VA
Enumeration date
08/30/2005
Last updated
04/15/2020
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