Moffett, Colin Lee

Moffett, Colin Lee is an sole proprietor health care provider with primary practice located at 111 E 3Rd Ave , Gastonia NC 28052-4317. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Moffett, Colin Lee can be contacted via phone (704) 874-3300.

Contact Information

Primary practice address
111 E 3Rd Ave Gastonia NC 28052-4317
Phone: (704) 874-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 139 North Carolina
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 139 North Carolina

Profile Details

NPI number 1568411007
LBN Legal business name Moffett, Colin Lee
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2006
Last updated May 3rd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568411007 NPPES
North Carolina Other 56-1384996 TAX ID
North Carolina MEDICAID 8908125 TAX ID
North Carolina Other 08125 TAX ID

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