Individual
DR. RAYMOND MICHAEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 VA AVENUE NE, SUITE 101, NORTON, VA 24273-1539
(276) 679-2555
(276) 679-2680
Mailing address
280 VA AVENUE NE, SUITE 101, NORTON, VA 24273-1539
(276) 679-2555
(276) 679-2680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101042256
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000101600
FEDERAL BLACK LUNG
VA
05
—
005612713
—
VA
01
—
258965
ANTHEM BLUE CROSS/SHIELD
VA
01
—
P00065331
RAILROAD MEDICARE
VA
Enumeration date
07/13/2006
Last updated
05/14/2013
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