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NPI Code Detail

MEDICARE: LAURA MELINDA MORETZ MD

MEDICARE: LAURA MELINDA MORETZ 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
1207Q00000XFamily Medicine Physician11066SC

Other Identifiers

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

General Provider Information

NPI Number : 1912951815
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA MELINDA MORETZ MD
Provider Business Mailing Address
First Line : 801 W MAIN ST
Second Line :
City : UNION
State : SC
Zip : 29379-2717
Country : US
Telephone Number : 864-429-8029
Fax Number : 864-429-3515
Provider Business Practice Location Address
First Line : 801 W MAIN ST
Second Line :
City : UNION
State : SC
Zip : 29379-2717
Country : US
Telephone Number : 864-429-8029
Fax Number : 864-429-3515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 08/23/2013

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Directions to “ LAURA MELINDA MORETZ MD” Practice Location

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