Provider Demographics
NPI:1588822316
Name:MOORE, MARGRETTE MACFIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGRETTE
Middle Name:MACFIE
Last Name: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 1:742 VIA SACRA
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-5638
Mailing Address - Country:US
Mailing Address - Phone:804-301-5799
Mailing Address - Fax:
Practice Address - Street 1:742 VIA SACRA
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-5638
Practice Address - Country:US
Practice Address - Phone:804-301-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247831208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty