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Individual

DR. CHARLES M. MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1359 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-1727
(573) 335-7546
(573) 335-7550
Mailing address
2116 MEGAN DR, STE 102, CAPE GIRARDEAU, MO 63701-1979
(573) 335-7546
(573) 335-7550

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01053751A
IN
207N00000X
Dermatology Physician
Primary
2007038037
MO

Other

Enumeration date
12/05/2006
Last updated
01/31/2017
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