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David Myungkee Moon

Radiology

Allopathic & Osteopathic Physicians

3600 Minnesota Dr Ste 800, Edina, MN 55435-7915

PECOS Enrollment

This provider is enrolled in PECOS as DAVID MOON.

Based on the most recent information from CMS, provider David Myungkee Moon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1548213812
Provider Type
Individual
Full Name
Moon, David Myungkee
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/18/2006
Last Updated
12/4/2024

Contact Information

Practice Location

3600 Minnesota Dr Ste 800, Edina, MN 55435-7915

(952) 595-1100

(612) 294-4903

Mailing Location

3600 Minnesota Dr Ste 800, Edina, MN 55435-7915

(952) 595-1301

(612) 294-4903

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License A74811 California
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 042-0011269 Vermont
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 10202 Nevada

David Myungkee Moon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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