MARCUS ANTWONE MOON (NPI# 1104334275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104334275 |
| Entity Type | Individual |
| Full Name | MARCUS ANTWONE MOON |
| Practice Address |
1825 Parker Rd Se Apt 105 Conyers GA 30094-2644 |
| Practice Telephone | 4045479678 |
| Mailing Telephone | 4045479678 |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2279P3900X |
Respiratory Therapist, Registered Specialization: Neonatal/Pediatrics |
007330 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1825 PARKER RD SE APT 105 |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 2279P3900X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Respiratory Therapist, Registered |
| Specialization | Neonatal/Pediatrics |
| The care and treatment of premature infants, newborns and children. This includes management of mechanical ventilation, assessment, diagnostics and generalized respiratory treatments. |
Please comment or provide details below to improve the information on MARCUS ANTWONE MOON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.