Individual
EDMUND K MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 3 RAVDIN BLDG, SUITE F, PHILADELPHIA, PA 19104-4206
(215) 662-3202
Mailing address
3400 SPRUCE ST, 3 RAVDIN BLDG, SUITE F, PHILADELPHIA, PA 19104-4206
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD440451
PA
207RP1001X
Pulmonary Disease Physician
MT184806
PA
Other
Enumeration date
07/24/2007
Last updated
06/09/2011
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