Individual
DR. JOHN T MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
2055 EXCHANGE ST STE 270, ASTORIA, OR 97103-3419
(503) 338-4670
Mailing address
2111 EXCHANGE ST, ASTORIA, OR 97103-3329
(503) 325-4321
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0440321
KS
208600000X
Surgery Physician
Primary
MD156549
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603700
—
NY
Enumeration date
10/04/2006
Last updated
08/29/2024
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