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Contact Information

JACK MOORE, MD
3800 RESERVOIR RD NW
WASHINGTON, DC20007-2113
 Phone: 202-877-6034
 Fax: 202-877-8329
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for JACK MOORE · (Male)

NPI Number 1467426221
Status Active
Credentials MD
Entity Individual
Enumeration date 02/16/2006
Last updated 06/16/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • DC License # MD19916
  • DC Medicaid 025615700
  • MD Medicaid 042931700
  • VA Medicaid 5817889
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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