Basic Information
| Provider Information | |||||||||
| NPI: | 1669869632 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOXLEY | ||||||||
| FirstName: | MEAGHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1250 E MARSHALL STREET | ||||||||
| Address2: | BOX 980163 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048289357 | ||||||||
| FaxNumber: | 8048285466 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 MCHENRY RD STE 3300 | ||||||||
| Address2: | |||||||||
| City: | ABERDEEN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210012682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438436100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2015 | ||||||||
| LastUpdateDate: | 12/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D87761 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | D87761 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RE0101X | D87761 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.