Individual
MOUSTAFA A MOUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3709 MAGNOLIA ST, ORANGEBURG, SC 29118-1403
(803) 531-2220
(803) 531-7975
Mailing address
PO BOX 2981, ORANGEBURG, SC 29116-2981
(803) 531-2220
(803) 531-7975
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
17881
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178818
—
SC
Enumeration date
10/13/2006
Last updated
06/19/2013
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