Individual
MARK CHRISTIAN MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1011 FRONTAGE RD, GREENVILLE, SC 29615-4240
(864) 242-4263
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35822
SC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
35822
SC
2086S0105X
Surgery of the Hand (Surgery) Physician
35822
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358222
—
SC
Enumeration date
06/08/2013
Last updated
08/24/2022
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