| Youngsik Moon, M.d., P.a. | |
|
24435 Mervell Dean Rd Hollywood MD 20636-2712 | |
| (301) 373-2116 | |
| (301) 373-5281 |
| Full Name | Youngsik Moon, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 24435 Mervell Dean Rd, Hollywood, Maryland |
| Authorized Official Name and Position | Betty Ann Quade (BUSINESS MANAGER) |
| Authorized Official Contact | 3013732116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youngsik Moon, M.d., P.a. 24435 Mervell Dean Rd Po Box 37 Hollywood MD 20636-2712 Ph: (301) 373-2116 | Youngsik Moon, M.d., P.a. 24435 Mervell Dean Rd Hollywood MD 20636-2712 Ph: (301) 373-2116 |
| NPI Number | 1245447465 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 03/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245447465 | NPI | - | NPPES |
| 1307 | Other | DC | CAREFIRST BCBS OF DC |
| 1010188 | Other | AETNA HMO | |
| 112048 | Other | MD | AMERIGROUP |
| 2120400 | Other | CIGNA | |
| KQ75 | Other | MD | CAREFIRST BCBS OF MD |
| 145464300 | Other | OWCP | |
| DG3783 | Other | MD | RAILRAOD MEDICARE |
| 531541700 | Medicaid | MD | |
| 5972624 | Other | AETNA PPO | |
| 818489 | Other | MAMSI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | D09178 (Maryland) | Secondary |
| 208600000X | Surgery | D09178 (Maryland) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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