Individual
MS. BONNY LAUREN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4501 EMPIRE CT, FREDERICKSBURG, VA 22408-1949
(540) 371-0079
(540) 656-2653
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101249938
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902048051
—
VA
Enumeration date
04/02/2009
Last updated
02/20/2026
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