Individual
DR. AMANDA THERESA MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
219 N BROAD ST, 4TH FLOOR, PHILADELPHIA, PA 19107-1519
(215) 762-5550
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1320
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD013064E
PA
Other
Enumeration date
06/14/2010
Last updated
09/13/2016
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