Brian Luther Moore
Individual provider Active NPI Contractor · Silver Spring, MD
NPI 1114768652 · NPPES record last updated Jun 6, 2024
Key facts
- NPI
- 1114768652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 11534 Lockwood Dr Apt B2
Silver Spring, MD 20904-2422 - Phone
- (202) 852-2047
- NPI assigned
- Jun 6, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agreatwork, LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MD | Yes | |
| Adult Companion | 372600000X | MD |
Addresses
Primary practice location
11534 Lockwood Dr Apt B2
Silver Spring, MD 20904-2422
Mailing address
11534 Lockwood Dr Apt B2
Silver Spring, MD 20904-2422
Phone (202) 852-2047
Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.