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Individual

DURMAN WILLIAM MOOSE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1601 ABBEY PL, STE 105, CHARLOTTE, NC 28209-3835
(704) 512-5360
(704) 512-5080
Mailing address
PO BOX 78030, CHARLOTTE, NC 28271-7023
(704) 458-9431
(704) 844-0648

Taxonomy

Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
32543
NC
208600000X
Surgery Physician
32543
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8960533
NC
05
N32543
SC
Enumeration date
08/31/2006
Last updated
11/09/2012
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