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Organization
SANTEE COOPER OB GYN ASSOC PA
Active
Organization
SANTEE COOPER OB GYN ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORWIN TILLMAN MOORE MD (PRESIDENT)
(803) 433-7262
Entity
Organization
Contact information
Practice address
1014 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7262
(803) 433-7271
Mailing address
1014 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7262
(803) 433-7271
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0617
—
SC
Enumeration date
07/20/2006
Last updated
11/19/2011
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