Basic Information
| Provider Information | |||||||||
| NPI: | 1932148749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOORMAN | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12622 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816482 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 521 WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | CHESTERTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216201217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108100767 | ||||||||
| FaxNumber: | 4106301677 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 12/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D45212 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 133341100 | 05 | MD | MEDICAID | Y945-002 | 01 | MD | CAREFIRST PRODUCTS | OTHER | 1176465 | 01 | MD | CIGNA | OTHER | 4592086 | 01 | MD | AETNA HMO AND PPO | OTHER | 217972 | 01 | MD | JHHC - EHP, PRIORITY PARTNERS, USFHP | OTHER | 607156016 | 01 | MD | FEDERAL EMPLOYEES WORKER COMP (FECA) | OTHER |