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
Fax: (704) 978-2380
Website:

Health care specialties

SpecialtyCodeLicense #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 4 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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