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Individual

DR. ELIZABETH JAYNE MOFFATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-8146
(803) 936-8916
Mailing address
PO BOX 2375, WEST COLUMBIA, SC 29171-2375
(803) 936-8146
(803) 936-8916

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
19801
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
19801
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q00158
SC
Enumeration date
04/04/2006
Last updated
03/02/2016
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