Individual
DR. SUSAN J. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
112 CROFTON PLACE, UVA LAKE MONTICELLO INTERNAL MEDICINE, PALMYRA, VA 22963
(434) 589-9030
(434) 589-9040
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101041674
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005803543
—
VA
Enumeration date
07/20/2006
Last updated
11/14/2008
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