Organization
CAROLINA UROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY ALAN MOSES MD (OWNER)
(910) 610-1113
Entity
Organization
Contact information
Practice address
521 E LAUCHWOOD DR, LAURINBURG, NC 28352-5502
(910) 610-1113
(910) 610-1105
Mailing address
521 E LAUCHWOOD DR, LAURINBURG, NC 28352-5502
(910) 610-1113
(910) 610-1105
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110W
BLUE CROSS BLUE SHIELD
NC
05
—
790110W
—
NC
05
—
8960187
—
NC
Enumeration date
06/19/2006
Last updated
10/31/2007
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