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NPI Code Detail

MEDICARE: DR. JAMIE M MOORE PSYD

MEDICARE:  DR. JAMIE M MOORE  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLP5380MN

General Provider Information

NPI Number : 1952537490
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMIE M MOORE PSYD
Provider Business Mailing Address
First Line : 6050 GORGAS RD
Second Line :
City : FORT BELVOIR
State : VA
Zip : 22060-6206
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : WIESBADEN ARMY HEALTH CLINIC
Second Line :
City : WIESBADEN
State : DC
Zip : 22060-6206
Country : US
Telephone Number : 314-590-1518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2009
Last Update Date : 10/24/2023

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Directions to “ DR. JAMIE M MOORE PSYD” Practice Location

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