Individual
MARK MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7707 PARAGON RD STE 101, CENTERVILLE, OH 45459
(937) 208-6920
(937) 208-6948
Mailing address
PO BOX 3266, ST AUGUSTINE, FL 32085-3266
(904) 819-4602
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.126007
OH
207R00000X
Internal Medicine Physician
ME79597
FL
Other
Enumeration date
05/05/2006
Last updated
10/05/2020
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