MEDICARE: DR. AMANDA MOYER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	32277	OK
2	208000000X	Pediatrics Physician	32277	OK

General Provider Information

NPI Number	:	1225485741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MOYER M.D.

Provider Business Mailing Address
First Line	:	1122 NE 13TH ST # 274
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73117-1039
Country	:	US
Telephone Number	:	405-271-5955
Fax Number	:	405-271-8852

Provider Business Practice Location Address
First Line	:	711 STANTON L YOUNG BLVD STE 524
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5022
Country	:	US
Telephone Number	:	405-271-5955
Fax Number	:	405-271-8852

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	02/10/2026

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