MEDICARE: DURMAN WILLIAM MOOSE JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	32543	NC
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	32543	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174635601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DURMAN WILLIAM MOOSE JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 78030
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28271-7023
Country	:	US
Telephone Number	:	704-458-9431
Fax Number	:	704-844-0648

Provider Business Practice Location Address
First Line	:	1601 ABBEY PL
Second Line	:	STE 105
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3835
Country	:	US
Telephone Number	:	704-512-5360
Fax Number	:	704-512-5080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/09/2012

Similar Medicare Providers

1023009321 — JAMES A. WATKINS M.D.
Practice Location Address:

1601 ABBEY PL , STE. 105
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-5360
Practice Fax: 704-512-5080

1841304748 — DOUGLAS B KIRSCH MD
Practice Location Address:

1601 ABBEY PL , STE 200
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-2980
Practice Fax:

1558441576 — MICHAEL T. BRENNAN DDS
Practice Location Address:

1601 ABBEY PL , STE 220
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-2110
Practice Fax:

1588754774 — JACKSON P MORGAN III DDS
Practice Location Address:

1601 ABBEY PL , STE 220
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-2110
Practice Fax:

1265578074 — JOEL JUSTIN NAPENAS DDS
Practice Location Address:

1601 ABBEY PL , STE 220
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-2110
Practice Fax:

1225235203 — JOEL MARTIN LAUDENBACH DMD
Practice Location Address:

1601 ABBEY PL , STE 220
CHARLOTTE, NC
28209-3835

Practice Phone: 704-512-2110
Practice Fax:

Directions to “ DURMAN WILLIAM MOOSE JR. MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.