Individual
DR. LARA WEAR MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
(843) 973-5415
(833) 994-1101
Mailing address
1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
(843) 973-5415
(833) 994-1101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16081
NH
207Q00000X
Family Medicine Physician
Primary
84179
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3086968
—
NH
05
—
841799
—
SC
Enumeration date
06/26/2008
Last updated
03/25/2026
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