MEDICARE: DR. RUTH S. MOOREVILLE MD

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	208000000X	Pediatrics Physician	MD039027L	PA
2	208D00000X	General Practice Physician	MD039027L	PA

General Provider Information

NPI Number	:	1538162219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH S. MOOREVILLE MD

Provider Business Mailing Address
First Line	:	P.O. BOX 191
Second Line	:
City	:	ROCKLAND
State	:	DE
Zip	:	19723-0191
Country	:	US
Telephone Number	:	302-651-4000
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	110 WEST LANCASTER AVENUE, SUITE 200
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-4061
Country	:	US
Telephone Number	:	610-293-2229
Fax Number	:	610-293-2231

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/28/2016

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