Individual
DR. J DAVID MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23 BUENA VISTA WAY, STE B, GREENVILLE, SC 29615
(864) 315-3736
(864) 315-3736
Mailing address
1491 ALTAMONT RD, GREENVILLE, SC 29609-6211
(864) 546-8284
(864) 315-3736
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
040166
GA
2084P0800X
Psychiatry Physician
Primary
35169
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351693
—
SC
Enumeration date
08/13/2006
Last updated
01/31/2021
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