Individual
ETHAN JUNO MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11140 ROCKVILLE PIKE STE 100, ROCKVILLE, MD 20852-3149
(240) 575-6210
(240) 877-0511
Mailing address
354 SOUTHWOOD DR, OXFORD, AL 36203-5020
(240) 575-6210
(240) 877-0511
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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