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General NPI Number Information
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NPI Number | 1598180689
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Entity Type | Organization
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Legal Business Name | DAI OK MOON MD PA
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 05/30/2014
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Provider Practice Location Address
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Address Line | 701 NORTH CLAYTON STREET ST FRANCIS HOSPITAL
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City | WIMINGTON
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State | DE
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Zip | 19805
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Country | US
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Telephone | 302-731-0600
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Fax | 302-731-0605
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Provider Business Mailing Address
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Address Line | C-83 OMEGA DRIVE
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City | NEWARK
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State | DE
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Zip | 19713
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Country | US
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Telephone | 302-731-0600
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Fax | 302-731-0605
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Authorized Official
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Title or Position | OWNER
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Name | DAI O MOON
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Credential | MD, PA
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Telephone | 302-731-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | C1-0002324
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C10002324
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License Number State | DE
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