Individual
TIMOTHY M MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2385 E PRATER WAY, SUITE 205, SPARKS, NV 89434-9629
(775) 356-4888
(775) 356-4890
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(775) 356-4888
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0008
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11041250
CAQH
—
01
—
1891716478
NPI
—
05
—
1891716478
—
NV
Enumeration date
07/21/2006
Last updated
05/08/2018
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