Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 17297 | KY |
NPI | 1164414488 |
---|---|
Provider Name | Ronald Peter Moyer |
First Address | Louisville, KY 40215-3102 |
Second Address | Louisville, KY 40215-1190 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 08/07/2007 |