Provider Demographics
NPI:1093899429
Name:MOYER, KAREN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:MOYER
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 1:921 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2102
Mailing Address - Country:US
Mailing Address - Phone:423-265-5708
Mailing Address - Fax:423-265-5713
Practice Address - Street 1:730 E 11TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3103
Practice Address - Country:US
Practice Address - Phone:423-265-5708
Practice Address - Fax:423-265-5713
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD20593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE69050Medicare UPIN
TN3055810Medicare ID - Type Unspecified