Provider Demographics
NPI:1851488399
Name:MORIARTY, MARK H (M D)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:MORIARTY
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-0569
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:56 MEDICAL PARK DR
Practice Address - Street 2:SUITE 303
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2632
Practice Address - Country:US
Practice Address - Phone:828-349-8260
Practice Address - Fax:828-349-8261
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34691207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCL882AMedicare PIN
NC8910876Medicaid
NC2022240Medicare ID - Type Unspecified