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Individual

JOHN DAVIS MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
58651
TN
207LP3000X
Pediatric Anesthesiology Physician
Primary
88397
SC
207LP3000X
Pediatric Anesthesiology Physician
A119480
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
SC
Enumeration date
03/17/2006
Last updated
09/22/2022
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