Kenneth T Moon (NPI# 1972591345, PAC ID# 2264620947) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1972591345 |
| PAC ID by PECOS | 2264620947 |
| Professional Enrollment ID | I20161130002412 |
| Full Name | Kenneth T Moon |
| Address |
24435 Mervell Dean Rd Hollywood MD 20636-2712 |
| Gender | M |
| Medical School | EASTERN VIRGINIA MEDICAL SCHOOL |
| Graduation Year | 1998 |
| Primary Specialty | FAMILY PRACTICE |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 |
| Street Address |
24435 MERVELL DEAN RD |
| City | HOLLYWOOD |
| State | MD |
| Zip | 20636-2712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle Munson | Nurse Practitioner | Youngsik Moon, M.d., P.a. | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 |
| Youngsik Moon | General Surgery | Youngsik Moon, M.d., P.a. | 24435 Mervell Dean Rd, Hollywood, MD 20636-2712 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carol Marcy | Clinical Psychologist | Carol Marcy, Ph.d., LLC. | 43288 Joy Ln, Hollywood, MD 20636-2608 |
| Pamela M Chaney | Physical Therapy | Chaney Physical Therapy Inc | 26045 Sotterley Heights Rd, Hollywood, MD 20636-2659 |
| Julie Ann Wilkening | Chiropractic | Harbor Bay Clinic of Chiropractic, LLC | 23620 Three Notch Rd, Suite 104, Hollywood, MD 20636-3083 |
| Stacey Dent | Chiropractic | Harbor Bay Clinic of Chiropractic, LLC | 23620 Three Notch Rd, Suite 104, Hollywood, MD 20636-3083 |
| Birgit Locklear | Clinical Social Worker | Pathways Inc | 44101 Airport View Dr, Hollywood, MD 20636-3145 |
| Ann-marie A Anderson | Nurse Practitioner | Pathways Inc | 44101 Airport View Dr, Hollywood, MD 20636-3145 |
| Jasmine Harris | Clinical Social Worker | Pathways Inc | 44101 Airport View Dr, Hollywood, MD 20636-3145 |
| Lisa Y Reichard | Psychiatry | Pathways Inc | 44101 Airport View Dr, Hollywood, MD 20636-3145 |
| Julie Logan | Clinical Social Worker | Pathways Inc | 44101 Airport View Dr, Hollywood, MD 20636-3145 |
| Colleen D Jude | Internal Medicine | 23348 Nicholson St, Hollywood, MD 20636-3287 | |
| Find all physicians in zip 20636 | |||
| City | HOLLYWOOD |
| Zip Code | 20636 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | HOLLYWOOD + FAMILY PRACTICE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.