Provider Demographics
NPI:1861477077
Name:MOYER, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:MOYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3309
Mailing Address - Country:US
Mailing Address - Phone:302-674-4627
Mailing Address - Fax:302-674-4628
Practice Address - Street 1:1100 FORREST AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3309
Practice Address - Country:US
Practice Address - Phone:302-674-4627
Practice Address - Fax:302-674-4628
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003264207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE207RR0500XOtherTAXONOMY
DE232589680OtherCOMMERCIAL
DE0000108501Medicaid
DE44896OtherCOVENTRY HEALTH CARE
DE426901T89Medicare ID - Type UnspecifiedMEDICARE ID
DE0000108501Medicaid