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General NPI Number Information
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NPI Number | 1366415309
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Entity Type | Individual
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Provider Name | SCOTT D.M. MOON M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST THE QUEEN'S MEDICAL CENTER DEPT OF RAD ONC
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City | HONOLULU
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State | HI
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Zip | 96813-2402
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Country | US
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Telephone | 808-691-4771
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Fax | 808-691-4507
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Provider Business Mailing Address
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Address Line | 1301 PUNCHBOWL ST THE QUEEN'S MEDICAL CENTER DEPT OF RAD ONC
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City | HONOLULU
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State | HI
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Zip | 96813-2402
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Country | US
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Telephone | 808-691-4771
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Fax | 808-691-4507
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD93402
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 7901
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License Number State | HI
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