Moore, Jacqueline Diana

Moore, Jacqueline Diana is an individual health care provider with primary practice located at 2280 Opitz Blvd Ste 110 , Woodbridge VA 22191-3362. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Moore, Jacqueline Diana can be contacted via phone (703) 523-8860.

Contact Information

Primary practice address
2280 Opitz Blvd Ste 110 Woodbridge VA 22191-3362
Phone: (703) 523-8860
Fax: (855) 462-1102
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X S2120 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101270338 Virginia

Profile Details

NPI number 1619173838
LBN Legal business name Moore, Jacqueline Diana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2007
Last updated Aug 20th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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