Healthcare Provider Details

I. General information

NPI: 1205923810
Provider Name (Legal Business Name): CLAUDE THURMAN MOORMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/25/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MOREHEAD MEDICAL DR STE 300
CHARLOTTE NC
28204-2963
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 704-446-2060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number39201
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number39201
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: