MEDICARE: DR. WILLIAM SCOTT MOORE M.D.

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	207RN0300X	Nephrology Physician	23953	NC
2	207R00000X	Internal Medicine Physician	23953	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60539	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407855968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM SCOTT MOORE M.D.

Provider Business Mailing Address
First Line	:	730 HIGHLAND OAKS DR
Second Line	:	SUITE 201
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27103-7108
Country	:	US
Telephone Number	:	336-768-2425
Fax Number	:	336-768-4915

Provider Business Practice Location Address
First Line	:	730 HIGHLAND OAKS DR
Second Line	:	SUITE 201
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27103-7108
Country	:	US
Telephone Number	:	336-768-2425
Fax Number	:	336-768-4915

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/12/2013

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Directions to “ DR. WILLIAM SCOTT MOORE M.D.” Practice Location

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