Individual
DR. RUSSELL RAY MOORES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 E MARSHALL STREET, PEDIATRICS, RICHMOND, VA 23298-0510
(804) 828-9602
(804) 828-8517
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0101245140
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
D41551
MD
Other
Enumeration date
10/19/2006
Last updated
09/28/2009
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