Healthcare Provider Details

I. General information

NPI: 1124553938
Provider Name (Legal Business Name): ROBERT JEFFREY MOYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2017
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

11 CROSS ST APARTMENT A
DANVILLE PA
17821-1634
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6211
  • Fax:
Mailing address:
  • Phone: 570-394-3665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD474809
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: