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General NPI Number Information
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NPI Number | 1376794891
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Entity Type | Organization
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Legal Business Name | HENRY MOYLE M.D., PHD, PC
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 8501 ARLINGTON BLVD 330
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City | FAIRFAX
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State | VA
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Zip | 22031-4617
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Country | US
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Telephone | 703-876-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 8501 ARLINGTON BLVD 330
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City | FAIRFAX
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State | VA
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Zip | 22031-4617
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Country | US
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Telephone | 703-876-4270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HENRY MOYLE
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Credential | M.D.
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Telephone | 703-876-4270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 0101243001
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License Number State | VA
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