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Individual

JAMES B. MOFFAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN235347L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
030859
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019709850003
PA
01
0531587
KHP CENTRAL
PA
01
0734755000
INDEP. BLUE CROSS
PA
01
11803039
CAQH
PA
01
1544275
GATEWAY
PA
01
50010794
CAPITAL ADVANTAGE
PA
01
76108
GEISINGER
PA
01
7790267
AETNA
PA
Enumeration date
09/30/2005
Last updated
03/25/2013
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