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Individual

DR. DORWIN TILLMAN MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2850 PELHAM CT, ORANGEBURG, SC 29118-1400
(803) 395-3737
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
15840
SC
207V00000X
Obstetrics & Gynecology Physician
MD19789
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3380640
MEDICARE GROUP
TN
01
7389
MEDICARE GROUP PTAN
SC
Enumeration date
03/30/2006
Last updated
01/26/2021
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