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General NPI Number Information
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NPI Number | 1104212471
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Entity Type | Individual
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Provider Name | KEVIN FRANCIS MOORE DO
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Gender | Male
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 9105 FRANKLIN SQUARE DR STE 104
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City | BALTIMORE
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State | MD
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Zip | 21237-5334
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Country | US
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Telephone | 443-777-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 500 WESTOVER DR # 12304
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City | SANFORD
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State | NC
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Zip | 27330-8941
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H98288
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License Number State | MD
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