Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 13915 | NH |
N | 207NS0135X | Procedural Dermatology | 040186 | CT |
NPI | 1003896036 |
---|---|
Provider Name | Dr. Stephen D Moyer |
First Address | Dover, NH 03820-2549 |
Second Address | Nashua, NH 03062-1310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 02/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4394277 | (05) | CT |
H55057 | (02) | CT |