Individual
EMILY MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 E GREENVILLE ST STE 2500, ANDERSON, SC 29621-1728
(864) 512-6810
(864) 224-1109
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-6810
(864) 224-1109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3138
SC
363AS0400X
Surgical Physician Assistant
Primary
3138
SC
Other
Enumeration date
01/18/2019
Last updated
01/05/2023
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