Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark G. Moore, PA-C

Individual provider Physician Assistant · NPI 1861504326

Mark G. Moore, PA-C is a Physician Assistant in Fort Lee, Virginia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

700 24th St
Fort Lee, VA 23801-1716
Phone: (804) 734-9867
Fax: (877) 874-1008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3260 (GA)

Record details

NPI number1861504326
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 31, 2006
Last updated in NPPESJune 13, 2025
Certification dateJune 13, 2025
Mailing address700 24th St, Fort Lee, VA 23801-1716

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