Individual
STEPHANIE YUI MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 POWERS FERRY RD SE, MARIETTA, GA 30067-5491
(770) 980-0000
Mailing address
1640 POWERS FERRY RD SE BLDG 30-100, MARIETTA, GA 30067-1440
(770) 980-0000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10595
GA
Other
Enumeration date
04/23/2019
Last updated
11/14/2022
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