Healthcare Provider Details

I. General information

NPI: 1942241112
Provider Name (Legal Business Name): SHAWN S MOYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 CAPE HORN RD
RED LION PA
17356-9071
US

IV. Provider business mailing address

3141 CAPE HORN RD
RED LION PA
17356-9071
US

V. Phone/Fax

Practice location:
  • Phone: 717-246-5180
  • Fax: 717-246-2005
Mailing address:
  • Phone: 717-246-5180
  • Fax: 717-246-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD073665L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: