Organization
DR. CHRISTOPHER J. MOSHOURES OPTOMETRIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER J MOSHOURES O.D. (OWNER)
(910) 754-2020
Entity
Organization
Contact information
Practice address
208 SMITH AVE, SHALLOTTE, NC 28470-4458
(910) 754-2020
(910) 754-8811
Mailing address
PO BOX 867, SHALLOTTE, NC 28459-0867
(910) 754-2020
(910) 754-8811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158B
BLUE CROSS BCBS SHIELD OF NC
NC
05
—
890158B
—
NC
01
—
DC7507
RAILROAD MEDICARE
NC
Enumeration date
05/19/2006
Last updated
05/02/2024
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