Organization
SUMTER SURGICAL ASSOCIATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY P MOSES MD (PHYSICIAN-PARTNER)
(803) 778-0212
Entity
Organization
Contact information
Practice address
115 N SUMTER ST, SUITE 300, SUMTER, SC 29150-4972
(803) 778-0212
(803) 775-7258
Mailing address
115 N SUMTER ST, STE 300, SUMTER, SC 29150-4972
(803) 778-0212
(803) 775-7258
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1090
—
SC
Enumeration date
05/17/2006
Last updated
10/23/2007
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