1003849290 NPI number — DR. RAYMOND MOY M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003849290 NPI number — DR. RAYMOND MOY M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MOY

Provider First Name:

RAYMOND

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1003849290

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/22/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1829 REISTERSTOWN RD

Provider Second Line Business Mailing Address:

SUITE 205

Provider Business Mailing Address City Name:

BALTIMORE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21208-6320

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-602-9850

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

16 GREENMEADOW DR

Provider Second Line Business Practice Location Address:

SUITE G105

Provider Business Practice Location Address City Name:

TIMONIUM

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21093-3200

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-561-5773

Provider Business Practice Location Address Fax Number:

410-560-2327

Provider Enumeration Date:

07/09/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208000000X , with the licence number:  D0039462 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 5749822004 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 9981 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
• Identifier: 52295301 . This is a "CAREFIRST MARYLAND" identifier . This identifiers is of the category "OTHER".
• Identifier: 5329700 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 72675 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 039585 . This is a "JOHNS HOPKINS HEATLHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1765049 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1201189 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 2105540 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 708979 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 0017 . This is a "CAREFIRST DC" identifier . This identifiers is of the category "OTHER".
• Identifier: 281968 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
• Identifier: 151511000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".