Individual
HENRY S MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2098 TERON TRCE, STE150, DACULA, GA 30019-1662
(678) 730-1620
(678) 730-0858
Mailing address
2098 TERON TRACE, STE150, DACULA, GA 30019-1662
(678) 730-1620
(678) 730-0858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038311
GA
Other
Enumeration date
04/04/2006
Last updated
01/15/2010
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