Provider Demographics
NPI:1063809713
Name:MOFFAT, DAVID DOUGLAS II (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DOUGLAS
Last Name:MOFFAT
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:1850 LAUREL ST STE 1A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2658
Practice Address - Country:US
Practice Address - Phone:803-376-5982
Practice Address - Fax:803-376-5987
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2021-09-23
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Provider Licenses
StateLicense IDTaxonomies
SC100159664208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery