Individual
ERICA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
853 N CHURCH ST, SUITE 720, SPARTANBURG, SC 29303-3098
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
866758
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT1017
—
SC
01
—
P00662543
RAILROAD MEDICARE
SC
01
—
Q340473365
MEDICARE PIN
SC
01
—
Q340475019
MEDICARE PIN
SC
01
—
Q340475193
MEDICARE PIN
SC
01
—
Q340476066
MEDICARE PIN
SC
01
—
Q340476067
MEDICARE PIN
SC
Enumeration date
10/26/2006
Last updated
11/27/2017
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