Provider Demographics
NPI:1366013039
Name:BIGGS, MOSES EDDIE
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:EDDIE
Last Name:BIGGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2491
Mailing Address - Country:US
Mailing Address - Phone:252-802-4054
Mailing Address - Fax:252-802-4204
Practice Address - Street 1:107 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2491
Practice Address - Country:US
Practice Address - Phone:252-802-4054
Practice Address - Fax:252-802-4204
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC6102208000000X, 385HR2065X, 253Z00000X, 253Z00000X
HC6102253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC6102Medicaid