Individual
DR. DALE EDWARD MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
306 WEAVER AVE, EMPORIA, VA 23847-1232
(434) 917-0006
Mailing address
261 SANDY LN, BRACEY, VA 23919-2004
(434) 636-4303
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101058245
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007309091
—
VA
01
—
174922
ANTHEM
VA
01
—
48178
SENTARA
VA
Enumeration date
02/12/2007
Last updated
07/08/2007
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