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Individual
BRYAN SCOTT MOON
Active
Individual
BRYAN SCOTT MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23261
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200044388
RR MEDICARE
SC
01
—
576007863201
BCBS OF SC
SC
05
—
T73603
—
SC
Enumeration date
02/07/2006
Last updated
05/03/2008
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