Healthcare Provider Details

I. General information

NPI: 1093628083
Provider Name (Legal Business Name): MARGARET GRACE MOYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGGIE MOYER PA-C

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-4443
  • Fax:
Mailing address:
  • Phone: 610-954-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA068312
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: