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General NPI Number Information
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NPI Number | 1952297905
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Entity Type | Organization
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Legal Business Name | MOORE OBGYN LLC
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 7610 PENNSYLVANIA AVE STE 305
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 301-669-1870
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Fax | 301-669-1873
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Provider Business Mailing Address
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Address Line | 7610 PENNSYLVANIA AVE STE 305
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City | FORESTVILLE
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State | MD
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Zip | 20747-4764
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Country | US
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Telephone | 301-669-1870
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Fax | 301-669-1873
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Authorized Official
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Title or Position | PRACTICE ADMIN
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Name | BROOKE HENDERSON
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Credential |
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Telephone | 301-669-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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