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NPI Code Detail

MEDICARE: DAVID D. MOON

MEDICARE: DAVID D. MOON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician35693CO
2207P00000XEmergency Medicine PhysicianDR.0035693CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2930043980OTHERCORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245218627
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID D. MOON
Provider Business Mailing Address
First Line : P.O. BOX 173862
Second Line :
City : DENVER
State : CO
Zip : 80217-3862
Country : US
Telephone Number : 303-306-7783
Fax Number : 303-306-7753
Provider Business Practice Location Address
First Line : 4567 E. 9TH AVENUE
Second Line :
City : DENVER
State : CO
Zip : 80220-5337
Country : US
Telephone Number : 303-320-2455
Fax Number : 303-306-7753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 08/18/2015

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Directions to “ DAVID D. MOON ” Practice Location

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