Individual
JUNG JOO MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.M.S
Contact information
Practice address
2875 LAKEWOOD AVE SW # A5, ATLANTA, GA 30315-5801
(713) 904-0106
(862) 227-4081
Mailing address
2875 LAKEWOOD AVE SW STE 1138, ATLANTA, GA 30315-5801
(713) 904-0106
(862) 227-4081
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
70750
MN
208D00000X
General Practice Physician
76451
WI
208D00000X
General Practice Physician
Primary
90144
GA
390200000X
Student in an Organized Health Care Education/Training Program
646517
TX
Other
Enumeration date
04/12/2016
Last updated
04/23/2025
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