Individual
MR. THOMAS GEORGE MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
516 BRADFIELD CT, LEXINGTON, SC 29072-7592
(803) 356-9896
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
88930
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
3622
SC
Other
Enumeration date
03/11/2008
Last updated
08/26/2022
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