Moore, Lane Ingram

Moore, Lane Ingram is an individual health care provider with primary practice located at 845 82Nd Pkwy , Myrtle Beach SC 29572-4614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Moore, Lane Ingram can be contacted via phone (843) 449-9621.

Contact Information

Primary practice address
845 82Nd Pkwy Myrtle Beach SC 29572-4614
Phone: (843) 449-9621
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 22109 South Carolina

Profile Details

NPI number 1598723900
LBN Legal business name Moore, Lane Ingram
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jul 18th, 2011 - about 13 years ago

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 1598723900 NPPES
South Carolina MEDICAID 221094
South Carolina Other 67728
South Carolina MEDICAID 89063Y4

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