Individual
MR. MATTHEW EUGENE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
Mailing address
7 TROTTERS LN NW, ROME, GA 30165-2677
(706) 766-1944
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN222612
GA
363LF0000X
Family Nurse Practitioner
RN222612
GA
Other
Enumeration date
05/18/2017
Last updated
11/10/2025
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