Individual
JOHN L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 ROBERTS ST, CAMDEN, SC 29020-3759
(803) 432-6186
(803) 432-1177
Mailing address
PO BOX 1259, SENTINEL HEALTH PARTNERS PA BUSINESS OFFICE, CAMDEN, SC 29021
(803) 713-8350
(803) 713-8433
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
7066
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070666
—
SC
01
—
81992
MEDCOST PIN
—
Enumeration date
05/17/2006
Last updated
11/06/2007
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