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General NPI Number Information
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NPI Number | 1134113327
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Entity Type | Individual
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Provider Name | SIMON C MOTEN MD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 600 MOYE BLVD LIFE SCIENCE BUILDING-CARDIOTHORACIC OUTPATIENT CLIN.
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City | GREENVILLE
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State | NC
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Zip | 27834-4300
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Country | US
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Telephone | 252-744-4822
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Fax | 252-744-5192
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Provider Business Mailing Address
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Address Line | PO BOX 751069
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City | CHARLOTTE
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State | NC
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Zip | 28275-1069
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Country | US
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Telephone | 252-744-3253
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Fax | 252-744-3194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State | NC
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