Provider Demographics
NPI:1437297249
Name:MOORS, WILLIAM RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RICHARD
Last Name:MOORS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1583
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-1583
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-654-7752
Practice Address - Street 1:310 AVON ST
Practice Address - Street 2:SUITE 9
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5750
Practice Address - Country:US
Practice Address - Phone:434-817-1818
Practice Address - Fax:434-817-9607
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101041148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E37947Medicare UPIN
VAP01514971Medicare PIN
VAVVG701AMedicare PIN