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EVERETT GERALD MOSS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7571
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
(803) 765-1732

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
247828
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
27845
SC

Other

Enumeration date
07/05/2023
Last updated
05/23/2024
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