Basic Information
| Provider Information | |||||||||
| NPI: | 1184983850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOORE | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170330858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175318955 | ||||||||
| FaxNumber: | 7175314587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2012 | ||||||||
| LastUpdateDate: | 02/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301100833 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD22105 | HI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207RC0200X | MD22105 | HI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207P00000X | MD464001 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.