Provider Demographics
NPI:1700450574
Name:MOYER, ROSS ROBERT (DO,)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:ROBERT
Last Name:MOYER
Suffix:
Gender:M
Credentials:DO,
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 GRIDOR STREET ECMC/DAVID K MILLER BLDG
Mailing Address - Street 2:INTERNAL MEDICINE RESIDENCY
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4578
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:462 GRIDOR STREET ECMC/DAVID K MILLER BLDG
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-4578
Practice Address - Fax:716-898-3279
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program