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Contact Information

MICHAEL R MOORE, DPT
628TH MEDICAL GROUP
204 WEST HILL BLVD
CHARLESTON, SC29404
 Phone: 804-571-5000
 Fax: 804-518-1314
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MICHAEL R MOORE · (Male)

NPI Number 1033422902
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 07/21/2010
Last updated 12/10/2025 - About 6 months ago
Sole proprietor 1 No
Identifiers
  • SC License # 8765
  • VA License # 2305206565
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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