Provider Demographics
NPI:1760467880
Name:MOORE, PARRY A (MD)
Entity Type:Individual
Prefix:
First Name:PARRY
Middle Name:A
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4801 DORSEY HALL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7766
Mailing Address - Country:US
Mailing Address - Phone:410-997-7660
Mailing Address - Fax:410-772-0257
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-997-7660
Practice Address - Fax:410-997-5377
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2010-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0021461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine