MOOSE HAND CENTER, PLLC (NPI# 1518222132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518222132 |
| Entity Type | Organization |
| Organization Name | MOOSE HAND CENTER, PLLC |
| Practice Address |
10502 Park Rd Suite 170 Charlotte NC 28210-8479 |
| Practice Telephone | 7043720527 |
| Practice Fax Number | 7043727564 |
| Mailing Telephone | 7043720527 |
| Mailing Fax Number | 7043727564 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | DR. DURMAN WILLIAM MOOSE JR. (PRESIDENT/OWNER) |
| Authorized Official Telephone | 7043720527 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
32543 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
10502 PARK RD SUITE 170 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-8479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321972 | Aaron T Blackmer | Physician Assistant | 10502 Park Rd, Suite 100, Charlotte, NC 28210-8479 | 2005-10-25 |
| 1578086187 | Carolinas Medical Center | Internal Medicine | 10502 Park Rd, Suite 110, Charlotte, NC 28210-8479 | 2017-07-25 |
| 1619400033 | Metrolina Dermatology and Skin Surgery Specialists, Pllc | Dermatology | 10502 Park Rd, Charlotte, NC 28210-8479 | 2017-04-04 |
| 1497181762 | Catherine Blair | Nurse Practitioner | 10502 Park Rd, Suite 150, Charlotte, NC 28210-8479 | 2013-09-18 |
| 1407144744 | David Olson | Internal Medicine | 10502 Park Rd, Ste 150, Charlotte, NC 28210-8479 | 2011-07-20 |
| 1669793303 | Corlan Eboh | Internal Medicine | 10502 Park Rd, Ste 150, Charlotte, NC 28210-8479 | 2010-06-17 |
| 1861719494 | Sasha Jenkins Haberle | Dermatology | 10502 Park Rd, Ste 100, Charlotte, NC 28210-8479 | 2010-04-21 |
| 1528380763 | Box Arthritis & Rheumatology of The | Clinic/Center | 10502 Park Rd, Suite 100, Charlotte, NC 28210-8479 | 2010-02-15 |
| 1265607907 | Nicholas Anthony | Internal Medicine | 10502 Park Rd, Ste 150, Charlotte, NC 28210-8479 | 2008-04-24 |
| 1821260498 | Thomas D Smith Dmd | Dentist | 10502 Park Rd, Suite 170, Charlotte, NC 28210-8479 | 2008-03-24 |
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|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
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| Taxonomy Code | 2086S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgery of the Hand |
| A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144351693 | Enamul Haque | Surgery | 3025 Springbank Ln, Ste #240, Charlotte, NC 28226-3362 | 2007-03-08 |
| 1598858250 | Carolina Hand Center, Pa | Surgery | 2711 Randolph Rd, Suite 305, Charlotte, NC 28207-2034 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922398080 | Caromont Medical Group Inc | Surgery | 2391 Court Dr, Suite 120a, Gastonia, NC 28054-2196 | 2011-04-11 |
| 1609833664 | Blue Ridge Plastic Surgery Group, Pllc | Surgery | 141 Doctors Dr, Boone, NC 28607-5017 | 2006-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.