Provider Demographics
NPI:1306847553
Name:MOORE, MARIA GARCIA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GARCIA
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LUISA
Other - Last Name:GARCIA-MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HOSPITAL DR STE 10B
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8024
Practice Address - Country:US
Practice Address - Phone:828-456-5214
Practice Address - Fax:828-456-7834
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063688207RH0003X
ME018372207RH0003X
CO49558207RH0003X
TXN8227207RH0003X
IA39385207RH0003X
SC27492207RH0003X
AL30669207RH0003X
OK29419207RH0003X
NC26241207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8934521Medicaid
NC34521OtherBCBS
SCAA61518157OtherMEDICARE PTAN
TX381360201Medicaid
NCP00284841OtherMEDICARE RAILROAD
SCAA61518157OtherMEDICARE PTAN
2158127CMedicare PIN