Individual
BRADLEY KELLER MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MEMORIAL DR, LURAY, VA 22835-1000
(540) 743-8018
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2888
(540) 535-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101261803
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0838087
BLUE SHIELD
PA
05
—
17782490001
—
PA
01
—
232809429
TRICARE
PA
01
—
321845
HEALTH AMERICA
PA
01
—
930083979
RAILROAD MEDICARE
PA
Enumeration date
07/21/2006
Last updated
03/29/2021
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