Individual
MICHAEL DENNIS MOXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 789-1892
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101053106
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
85994
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
859949
—
SC
01
—
9223
MEDICARE SC PTAN
SC
Enumeration date
10/11/2005
Last updated
09/09/2024
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