Individual
DR. GLEN L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 GAINSBOROUGH SQ, STE 400, CHESAPEAKE, VA 23320-1713
(757) 842-4499
(757) 842-1447
Mailing address
113 GAINSBOROUGH SQ, STE 400, CHESAPEAKE, VA 23320-1713
(757) 842-4499
(757) 842-1447
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101044198
VA
Other
Enumeration date
09/26/2006
Last updated
05/28/2013
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