Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD.35903 | AL |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 52501 | SC |
NPI | 1043574031 |
---|---|
Provider Name | Nathan Michael Moroski |
First Address | Greenville, SC 29615-4536 |
Second Address | Seneca, SC 29678 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 31/08/2018 |