Provider Demographics
NPI:1306968656
Name:ANTHONY J MOORMAN MD AND ASSOCIATES PC
Entity type:Organization
Organization Name:ANTHONY J MOORMAN MD AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JUDE
Authorized Official - Last Name:MOORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-810-0767
Mailing Address - Street 1:120 SPEER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1044
Mailing Address - Country:US
Mailing Address - Phone:410-810-0767
Mailing Address - Fax:410-810-0769
Practice Address - Street 1:120 SPEER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1044
Practice Address - Country:US
Practice Address - Phone:410-810-0767
Practice Address - Fax:410-810-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045212174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5376AJOtherBLUECROSS BLUESHIELD
MDW138OtherCAREFIRST BLUE CHOICE
MDW138OtherCAREFIRST BLUE CHOICE
MD=========OtherCOVENTRY HEALTHCARE
MD=========OtherUNITED HEALTHCARE
MD=========OtherMDIPA, OCI, MAMSI,ONE NET
MD=========OtherMARYLAND PHYSICIANS CARE
MD=========OtherAMERIGROUP MCO
MD=========OtherCOVENTRY HEALTHCARE
MD5376AJOtherBLUECROSS BLUESHIELD