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Individual
CHRISTOPHER A MOON
Active
Individual
CHRISTOPHER A MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000901A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490972
ANTHEM PROVIDER NUMBER
IN
05
—
200465420
—
IN
Enumeration date
08/10/2006
Last updated
03/23/2021
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