Individual
ALFRED DENTON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 W FARIS RD, GREENVILLE, SC 29605-4241
(864) 729-8330
(864) 751-0479
Mailing address
PO BOX 287, GREENVILLE, SC 29602-0287
(864) 729-8330
(864) 751-0479
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
010654
SC
207R00000X
Internal Medicine Physician
Primary
010654
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106548
—
SC
01
—
P00211213
RAILROAD-MEDICARE
SC
Enumeration date
06/13/2006
Last updated
10/26/2016
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