CHARLES B MOOMEY JR MD; NPI #1902003841

Contact Information

CHARLES B MOOMEY JR MD

631 PROFESSIONAL DRIVE
SUITE 300
LAWRENCEVILLE, GA 30046-3371

Phone: 770-962-9977
Fax: 770-339-9804
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Vascular Surgery	2086S0129X	76	Physician/Peripheral Vascular Disease

Indicates primary specialty

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NPI Profile & details for CHARLES B MOOMEY JR MD

NPI Number 1902003841

LBN Legal business name CHARLES B MOOMEY JR MD

Authorized official CHARLES MOOMEY - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/02/2007

Last updated 09/01/2010 - About 16 years ago

Identifiers

GA	License #	049923
GA	Medicaid	00899951A

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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CHARLES B MOOMEY JR MD

Contact Information

Specialty

Vascular Surgery

NPI Profile & details for CHARLES B MOOMEY JR MD

Reviews for CHARLES B MOOMEY JR MD