Provider Demographics
NPI:1356543193
Name:MOSKOS, FRANK (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:MOSKOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100567
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-0567
Mailing Address - Country:US
Mailing Address - Phone:843-777-2800
Mailing Address - Fax:843-777-2810
Practice Address - Street 1:144 N RAVENEL ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2641
Practice Address - Country:US
Practice Address - Phone:843-777-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41142207Q00000X
OH35-088560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC411423Medicaid
NCP00622953OtherRR MEDICARE
NC5909387Medicaid
NCP00622953OtherRR MEDICARE