Andrew Moultrie, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

D0068511 Issued in MD

Practice address

7555 Waterloo Rd
Jessup, MD 20794-9783

Phone

(410) 799-3400

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marian T Ebron, MD Internal Medicine PC

  • Legal Medicine (M.D./D.O.) Physician
  • Augusta, GA
  • NPI 1770818502
  NPD (past)
• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)
• McKinney Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Alma, GA
  • NPI 1134454911
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1376746545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6556 MEADOWFIELD CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756879",
            "telephone_number": "443-571-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 WATERLOO RD",
            "city": "JESSUP",
            "state": "MD",
            "postal_code": "207949783",
            "telephone_number": "410-799-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0068511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Management Specialists, Inc.
• Yash Mehta, D.M.D
• Mindful Moments, LLC
• Bobby Mitchell, M.SC.
• Shivangi Chandrashekhar Moghe, PSY.D.
• Mohammadu Enuah Mustapha
• George Suh Nde
• NP Care, LLC
• Lucrece Nsoesie
• Nadine Nwana

• General Practice Physician in Jessup, MD
• Providers in Jessup, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.