Individual
DR. JOHN BLAINE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-1043
Mailing address
620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH, PORTSMOUTH, VA 23708
(757) 953-1043
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
01076297A
IN
207R00000X
Internal Medicine Physician
01076297A
IN
207RH0003X
Hematology & Oncology Physician
Primary
01076297A
IN
Other
Enumeration date
04/28/2014
Last updated
01/13/2022
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