Individual
KAY L MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16 WOODCROSS DR, COLUMBIA, SC 29212-2331
(803) 732-0140
(803) 732-4848
Mailing address
74 POLO RD, COLUMBIA, SC 29223-2806
(803) 788-6146
(803) 462-0312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13663
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136631
—
SC
Enumeration date
08/24/2006
Last updated
07/19/2011
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