Individual
DR. EDGAR CHARLES MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
701 DOCTORS DR, SUITE A, KINSTON, NC 28501-1589
(252) 775-5999
(252) 208-1647
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2013-00327
NC
2086S0102X
Surgical Critical Care Physician
OS014259
PA
2086S0127X
Trauma Surgery Physician
OS014259
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497074041
—
NC
01
—
179J0
BCBS NC
NC
Enumeration date
05/21/2010
Last updated
05/11/2021
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