Individual
DR. PAUL MOBERG
Active
Individual
DR. PAUL MOBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
171890-1
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
171890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000406860004
BLUE SHIELD OF NORTHEASTERN NY
NY
05
—
01611123
—
NY
01
—
10001397
CDPHP
—
01
—
3006027
MVP HEALTHPLAN
NY
Enumeration date
07/13/2006
Last updated
01/21/2015
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