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NPI Code Detail

MEDICARE: MICHAEL DENNIS MOXLEY MD

MEDICARE: MICHAEL DENNIS MOXLEY 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
1207V00000XObstetrics & Gynecology Physician0101053106VA
2207V00000XObstetrics & Gynecology Physician85994SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19223OTHERSCMEDICARE SC PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1437147758
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DENNIS MOXLEY MD
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 843-789-1620
Fax Number : 843-724-2440
Provider Business Practice Location Address
First Line : 2095 HENRY TECKLENBURG DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5733
Country : US
Telephone Number : 843-789-1892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 09/09/2024

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