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Individual

DANIEL L MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
311 N 4TH ST, SUITE 101, OAKLAND, MD 21550-1371
(301) 334-8171
(301) 334-1819
Mailing address
311 N 4TH ST, SUITE 101, OAKLAND, MD 21550-1371
(301) 334-8171
(301) 334-1819

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R114948
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
334403700
MD
05
3810017953
WV
Enumeration date
07/22/2009
Last updated
09/05/2012
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