Provider Demographics
NPI:1003849290
Name:MOY, RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:MOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6320
Mailing Address - Country:US
Mailing Address - Phone:410-602-9850
Mailing Address - Fax:
Practice Address - Street 1:16 GREENMEADOW DR
Practice Address - Street 2:SUITE G105
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3200
Practice Address - Country:US
Practice Address - Phone:410-561-5773
Practice Address - Fax:410-560-2327
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0039462208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
5749822004OtherCIGNA
9981OtherKAISER
52295301OtherCAREFIRST MARYLAND
5329700OtherAETNA PPO
MD72675Medicaid
039585OtherJOHNS HOPKINS HEATLHCARE
1765049OtherUNITED HEALTHCARE
MD1201189Medicaid
2105540OtherAETNA HMO
708979OtherNCPPO
0017OtherCAREFIRST DC
281968OtherMAMSI
MD151511000Medicaid
MD72675Medicaid
370017550Medicare ID - Type UnspecifiedMEDICARE RAILROAD
20PPMedicare ID - Type Unspecified