Provider Demographics
NPI:1700866191
Name:MOORMAN, CYNTHIA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JOY
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4893
Mailing Address - Country:US
Mailing Address - Phone:301-662-4868
Mailing Address - Fax:301-662-0050
Practice Address - Street 1:77 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE K
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4893
Practice Address - Country:US
Practice Address - Phone:301-662-4868
Practice Address - Fax:301-662-0050
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054731208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD340020076OtherMEDICARE RAILROAD
MD223100000Medicaid