Individual
DR. TERESA A.F. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
312 KING STREET, KEYSVILLE, VA 23947-4540
(434) 736-8801
(434) 736-0292
Mailing address
PO BOX 927, 5 E ALVON ROAD, SUITE 7, WHITE SULPHUR SPRINGS, WV 24986-2373
(304) 536-5030
(304) 536-5051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101052933
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10026074
OPTIMA/SENTARA
VA
05
—
1871599282
—
VA
01
—
2605469
AETNA
VA
01
—
345650
ANTHEM
VA
01
—
453599
ANTHEM
VA
01
—
5116589
AETNA
VA
05
—
5625351
—
VA
01
—
61459601
BLACK LUNG/FECA
VA
01
—
6774742
CIGNA
VA
Enumeration date
06/22/2005
Last updated
10/15/2011
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