Dr. Phillip Schmitz Moore, MD
in Winston Salem, NC. Individual provider (NPI-1).
NPI number1215119151
StatusActive
Last updated in NPPESOct 28, 2020
Details
- NPI
- 1215119151
- Entity type
- Individual (NPI-1)
- Name
- Dr. Phillip Schmitz Moore
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 3, 2007
- Certification date
- Sep 6, 2020
- Last updated
- Oct 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | 2008-01396 | NC | Yes | |
| 208600000X | Surgery | 2008-01396 | NC |
Practice location
2827 Lyndhurst AveSuite 203
Winston Salem, NC 27103-4145
Phone 336-794-8624 · Fax 336-231-8845
Mailing address
Po Box 60447Charlotte, NC 28260-0447
Phone 336-794-8624 · Fax 336-231-8845
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