Individual
MRS. CHARLOTTE T. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
116 BASKERVILL DR, PAWLEYS ISLAND, SC 29585-6013
(843) 237-2672
(843) 237-0369
Mailing address
185 ROSSDHU AVE, PAWLEYS ISLAND, SC 29585-5871
(843) 237-8313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A246
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A246
PA LICENSE NUMBER
SC
Enumeration date
08/20/2006
Last updated
07/08/2007
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