Healthcare Provider Details

I. General information

NPI: 1407290901
Provider Name (Legal Business Name): THOMAS RYAN MOYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 COUNTRY CLUB RD
MONONGAHELA PA
15063-1013
US

IV. Provider business mailing address

110 29TH AVE N STE 202
NASHVILLE TN
37203-1448
US

V. Phone/Fax

Practice location:
  • Phone: 724-258-1841
  • Fax: 724-258-1686
Mailing address:
  • Phone: 615-327-4304
  • Fax: 615-327-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD0000049455
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD482619
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: