Doctor Name: | MARIO ALBERTO MORALES |
NPI Number: | 1013279926 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 0101255398 |
Business Practice Address: | 9300 Dewitt Loop Fort Belvoir, VA - 220605285 |
Business Phone Number: | 5712312892 |
Business Fax Number: | |
Mailing Address: | 9300 Dewitt Loop, FORT BELVOIR |
State: | VA |
Postal Code: | 220605285 |
Phone Number: | 5712312892 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2012 |
NPI Last Update Date: | 08/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0101255398 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |