Individual
KURTIS EUGENE MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
(540) 982-3434
Mailing address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
(540) 982-3434
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
128607
NC
208600000X
Surgery Physician
0101-253023
VA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
0101-253023
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VV8610A
MEDICARE PTAN
VA
Enumeration date
05/20/2008
Last updated
05/10/2021
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