Provider Demographics
NPI:1083731194
Name:RUBYE WASHINGTON MOORE AND ASSOCIATES
Entity Type:Organization
Organization Name:RUBYE WASHINGTON MOORE AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUBYE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WASHINGTON MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-323-3051
Mailing Address - Street 1:909 HIOAKS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4038
Mailing Address - Country:US
Mailing Address - Phone:804-323-3051
Mailing Address - Fax:804-323-1493
Practice Address - Street 1:909 HIOAKS RD
Practice Address - Street 2:SUITE E
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4038
Practice Address - Country:US
Practice Address - Phone:804-323-3051
Practice Address - Fax:804-323-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053243207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG18818Medicare UPIN