Organization
SANTEE COOPER OB GYN ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORWIN TILLMAN MOORE MD (PRESIDENT)
(803) 433-7262
Entity
Organization
Contact information
Practice address
1014 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7262
(803) 433-7271
Mailing address
1014 PROFESSIONAL CT, MANNING, SC 29102-2827
(803) 433-7262
(803) 433-7271
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0617
—
SC
Enumeration date
07/20/2006
Last updated
11/19/2011
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