Brian Luther Moore
Contractor in Silver Spring, MD. Individual provider (NPI-1).
NPI number1114768652
StatusActive
Last updated in NPPESJun 6, 2024
Details
- NPI
- 1114768652
- Entity type
- Individual (NPI-1)
- Name
- Brian Luther Moore
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 6, 2024
- Certification date
- Jun 6, 2024
- Last updated
- Jun 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | MD | Yes |
| 372600000X | Adult Companion | – | MD |
Practice location
11534 Lockwood Dr Apt B2Silver Spring, MD 20904-2422
Phone 202-852-2047
Mailing address
11534 Lockwood Dr Apt B2Silver Spring, MD 20904-2422
Phone 202-852-2047
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