Moore, Paul Derek

Moore, Paul Derek is an individual health care provider with primary practice located at 815 Cumberland St Suite 205, Lebanon PA 17042-5266. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Moore, Paul Derek can be contacted via phone (717) 277-7400.

Contact Information

Primary practice address
815 Cumberland St Suite 205 Lebanon PA 17042-5266
Phone: (717) 277-7400
Fax: (717) 277-7402
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 40759 Colorado
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD444618 Pennsylvania

Profile Details

NPI number 1417945700
LBN Legal business name Moore, Paul Derek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Sep 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417945700 NPPES
Colorado MEDICAID 09932861

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