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Individual

GENALYNNE CARWILE MOONEYHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1111 W 10TH ST, #201, INDIANAPOLIS, IN 46202-4800
(317) 274-7423
Mailing address
PO BOX 63362, #201, CHARLOTTE, NC 28263-3362
(919) 620-4918
(919) 620-4921

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
206-00815
NC

Other

Enumeration date
05/19/2011
Last updated
05/18/2016
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