Provider Demographics
NPI:1245324185
Name:MOORES, LEON ELWIN (MD, DSC)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:ELWIN
Last Name:MOORES
Suffix:
Gender:M
Credentials:MD, DSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 KENT OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5614
Mailing Address - Country:US
Mailing Address - Phone:301-295-2427
Mailing Address - Fax:
Practice Address - Street 1:3023 HAMAKER CT STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2240
Practice Address - Country:US
Practice Address - Phone:703-848-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31653207T00000X
VA0101255531207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery