Organization
COVENANT FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY SONG MOON MD (PARTNER)
(678) 730-1620
Entity
Organization
Contact information
Practice address
2098 TERON TRACE SUITE 150, DACULA, GA 30019
(678) 730-1620
(678) 730-0858
Mailing address
2098 TERON TRACE SUITE 150, DACULA, GA 30019
(678) 730-1620
(678) 730-0858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/07/2007
Last updated
01/15/2010
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