Individual
MATTHEW MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 N CAROLINE ST, BALTIMORE, MD 21287-0006
(410) 955-9446
Mailing address
4755 OGLETOWN STANTON RD, NEWARK, DE 19718-2200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
C1-0010155
DE
2085R0202X
Diagnostic Radiology Physician
Primary
D81267
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108076800
—
MD
Enumeration date
04/16/2011
Last updated
08/09/2017
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