Provider Demographics
NPI:1043440415
Name:MOELLER, MOLLY KATHLEEN BOYCE (MD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:KATHLEEN BOYCE
Last Name:MOELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:BOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-4021
Mailing Address - Fax:704-384-5601
Practice Address - Street 1:2630 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4318
Practice Address - Country:US
Practice Address - Phone:704-384-1000
Practice Address - Fax:704-384-1012
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2668208000000X
NC2011-01821208M00000X
NC201101821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist