Paul Derek Moore, MD is a
General Practice physician based in Lebanon, Pennsylvania. Paul Derek Moore is licensed to practice in Pennsylvania (license number MD444618) and his current practice location is 815 Cumberland St, Suite 205, Lebanon, Pennsylvania. He can be reached at his office (for appointments etc.) via phone at
(717) 277-7400.
NPI number for Paul Derek Moore is 1417945700 and his current mailing address is 100 N Cameron St, Suite 401e, Harrisburg, Pennsylvania. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417945700.
Physician's Profile
Full Name | Paul Derek Moore |
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Gender | Male |
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Speciality | General Practice |
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Location | 815 Cumberland St, Lebanon, Pennsylvania |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417945700
- Provider Enumeration Date: 10/11/2005
- Last Update Date: 09/23/2016
Medical Identifiers
Medical identifiers for Paul Derek Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417945700 | NPI | - | NPPES |
09932861 | Medicaid | CO | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 40759 (Colorado) | Secondary |
208D00000X | General Practice | MD444618 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Paul Derek Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Paul Derek Moore, MD 100 N Cameron St, Suite 401e, Harrisburg, PA 17101-2424 Ph: (717) 232-8535 | Paul Derek Moore, MD 815 Cumberland St, Suite 205, Lebanon, PA 17042-5266 Ph: (717) 277-7400 |
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