Provider Demographics
NPI:1083683734
Name:MOODY, MARY FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:MOODY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4020 WAKE FOREST ROAD
Mailing Address - Street 2:SUITE 201 ASSOCIATES IN WOMENS HEALTHCARE PA
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609
Mailing Address - Country:US
Mailing Address - Phone:919-876-9797
Mailing Address - Fax:919-790-1254
Practice Address - Street 1:4020 WAKE FOREST ROAD
Practice Address - Street 2:SUITE 201 ASSOCIATES IN WOMENS HEALTHCARE PA
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-876-9797
Practice Address - Fax:919-790-1254
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8960361Medicaid
NC001409379004OtherUNITED HEALTH CARE
NC1821484OtherCIGNA
NC35672OtherBCBS
2185343EMedicare ID - Type Unspecified
NC1821484OtherCIGNA