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Individual

JEFFREY S. MOLLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
176 MCSWAIN DR, WEST COLUMBIA, SC 29169-4825
(803) 767-4465
(803) 767-4120
Mailing address
9275 MEDICAL PLAZA DR STE F, NORTH CHARLESTON, SC 29406-9140
(803) 767-4465
(803) 767-4120

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101052466
VA
208600000X
Surgery Physician
200901168
NC
208600000X
Surgery Physician
Primary
84100
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010083401
VA
05
N0116E
SC
Enumeration date
04/13/2006
Last updated
07/12/2024
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