Provider Demographics
NPI:1659318996
Name:MOYER, ANDREA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:K
Last Name:MOYER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:222 S WOODS MILL RD
Mailing Address - Street 2:SUITE 500 NORTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3625
Mailing Address - Country:US
Mailing Address - Phone:314-205-6699
Mailing Address - Fax:314-205-6985
Practice Address - Street 1:222 S WOODS MILL RD
Practice Address - Street 2:SUITE 500 NORTH
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3625
Practice Address - Country:US
Practice Address - Phone:314-205-6699
Practice Address - Fax:314-590-5923
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2022-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2002014034207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207626524Medicaid
MO207626524Medicaid
956331930Medicare ID - Type UnspecifiedST. LOUIS NUMBER
956333022Medicare ID - Type UnspecifiedFARMINGTON NUMBER