Provider Demographics
NPI:1114948270
Name:WASHINGTON-MOORE, RUBYE DEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBYE
Middle Name:DEE
Last Name:WASHINGTON-MOORE
Suffix:
Gender:F
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:PO BOX 786
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-0786
Mailing Address - Country:US
Mailing Address - Phone:804-229-4216
Mailing Address - Fax:
Practice Address - Street 1:102 15TH ST NW
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1627
Practice Address - Country:US
Practice Address - Phone:276-439-1470
Practice Address - Fax:276-439-1471
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28483207V00000X
VA01010532432083A0300X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1114948270Medicaid
VA006206034Medicaid
VAG18810Medicare UPIN
VA1114948270Medicaid
VA160001197Medicare PIN