Individual
DR. SUMMER MOORER PAULATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1231 FOLLY RD, CHARLESTON, SC 29412-4105
(843) 795-3400
(843) 795-3435
Mailing address
28 AVONDALE AVE, CHARLESTON, SC 29407-7259
(843) 763-3990
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1420
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205268645
RR MEDICARE
SC
05
—
D14205
—
SC
Enumeration date
08/02/2006
Last updated
07/23/2008
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