Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Marissa Michelle Moultrie, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1235591769

Dr. Marissa Michelle Moultrie, MD is a Family Practice in Stafford, Virginia. Graduated from Medical University of South Carolina College of Medicine in 2016, 10 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
10
Trained at
Medical University of South Carolina College of Medicine
Licensed in
VA
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

125 Hospital Center Blvd Ste 110
Stafford, VA 22554-6202
Phone: (540) 602-6500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 29 S Paca St, Baltimore, MD 21201-1771 — (667) 214-1880

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101265808 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1235591769
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2016
Last updated in NPPESJune 6, 2021
Certification dateJune 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Stafford