Individual
MICHAEL MOOREVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
272 N LANSDOWNE AVE, LANSDOWNE, PA 19050-1143
(610) 259-3434
(610) 259-3480
Mailing address
272 N LANSDOWNE AVE, LANSDOWNE, PA 19050-1143
(610) 259-3434
(610) 259-3480
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD022478E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009582890001
—
PA
01
—
0031118000
IBC
PA
01
—
4612083
AETNA
NJ
01
—
4612083
AETNA
PA
Enumeration date
08/11/2006
Last updated
12/02/2008
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