Provider Demographics
NPI:1902068471
Name:MOATS, COURTNEY AMBER (MD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:AMBER
Last Name:MOATS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43480 YUKON DRIVE
Mailing Address - Street 2:STE. 206
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7915
Mailing Address - Country:US
Mailing Address - Phone:703-723-3201
Mailing Address - Fax:703-729-2736
Practice Address - Street 1:43480 YUKON DRIVE
Practice Address - Street 2:STE. 206
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7915
Practice Address - Country:US
Practice Address - Phone:703-723-2736
Practice Address - Fax:703-729-2736
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249617208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics