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General NPI Number Information
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NPI Number | 1467030866
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Entity Type | Individual
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Provider Name | ROBERT MOY MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD DIVISION OF PEDIATRIC NEPHROLOGY
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-590-2449
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 SCOTT AVE UNIT 434
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City | CHARLOTTE
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State | NC
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Zip | 28203-1518
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Country | US
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Telephone | 443-257-5830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | MT231446
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License Number State | PA
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