Provider Demographics
NPI:1700237187
Name:MOIT, HARLEY (DO)
Entity type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:MOIT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 TWO ISLAND CT UNIT 203
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7406
Mailing Address - Country:US
Mailing Address - Phone:843-971-2860
Mailing Address - Fax:
Practice Address - Street 1:1205 TWO ISLAND CT UNIT 203
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7406
Practice Address - Country:US
Practice Address - Phone:843-971-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.069371208600000X
IN02006435A2086S0122X
NC2024-009612086S0122X
SC935432086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300052313Medicaid