Moon, Tara
Moon, Tara is an individual health care provider with primary practice located at 1410 Fern Creek Dr , Statesville NC 28625-9376. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Moon, Tara can be contacted via phone (704) 978-2379.Contact Information
Primary practice address
1410 Fern Creek Dr
Statesville NC 28625-9376
Phone: (704) 978-2379
Fax: (704) 978-2380
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2015-01302 | North Carolina |
Profile Details
| NPI number | 1336403211 |
|---|---|
| LBN Legal business name | Moon, Tara |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2012 |
| Last updated | Sep 10th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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