Individual
MR. DONG YEON MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35000 DIVISION RD, SUITE 9, RICHMOND, MI 48062-1566
(586) 727-7209
(586) 727-7929
Mailing address
35000 DIVISION RD, SUITE 9, RICHMOND, MI 48062-1566
(586) 727-7209
(586) 727-7929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DM034395
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102813
PREFERRED CHOICES
—
01
—
110223882
RAILROAD MEDICARE
—
01
—
1105044541
BLUE CROSS
MI
05
—
2092217
—
MI
01
—
4035060
AETNA
—
01
—
C3196
M-CARE
MI
01
—
D91391
HAP
—
Enumeration date
11/04/2005
Last updated
12/21/2009
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