Provider Demographics
NPI:1699375360
Name:MOORE-PRESTON, ERIN ROSA (RTR)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ROSA
Last Name:MOORE-PRESTON
Suffix:
Gender:F
Credentials:RTR
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ROSA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RTR
Mailing Address - Street 1:US ARMY MEDICAL ACTIVITY-BAVARIA
Mailing Address - Street 2:UNIT 28038
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US ARMY MEDICAL ACTIVITY- BAVARIA
Practice Address - Street 2:UNIT 28038
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:637-194-6439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4639702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology