=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538443411
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUCIE VICTORIA MORAVIA D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2011
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7704 MATAPEAKE BUSINESS DR STE 315
-----------------------------------------------------
City | BRANDYWINE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20613-3046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-856-3062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7704 MATAPEAKE BUSINESS DR STE 315
-----------------------------------------------------
City | BRANDYWINE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20613-3046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-856-3062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 66951
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VM0101X
-----------------------------------------------------
Taxonomy Name | Maternal & Fetal Medicine Physician
-----------------------------------------------------
License Number | 0102209419
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207VM0101X
-----------------------------------------------------
Taxonomy Name | Maternal & Fetal Medicine Physician
-----------------------------------------------------
License Number | H0089677
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | OS016383
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------