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Individual

DR. CHRISTOPHER J MOSHOURES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4830 MAIN ST, SHALLOTTE, NC 28470-1912
(910) 754-2020
(910) 754-8811
Mailing address
PO BOX 867, SHALLOTTE, NC 28459-0867
(910) 754-2020
(910) 754-8811

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0868
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09626
BLUE CROSS BLUE SHIELD OF NC
NC
01
1770537268
RAILROAD MEDICARE
NC
05
890158B
NC
Enumeration date
05/20/2006
Last updated
01/29/2009
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