Michael Moon, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

054221 Issued in MI

Practice address

1101 W University Drive
Rochester, MI 48307-1831

Phone

(248) 652-5000

Fax

(248) 652-5605

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rochester Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Rochester, MI
  • NPI 1962430900
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366488157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80275",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483080275",
            "telephone_number": "248-652-5000",
            "fax_number": "248-652-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DRIVE",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071831",
            "telephone_number": "248-652-5000",
            "fax_number": "248-652-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "054221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "0637621",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102864",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inaam Mohammed
• Andrew Lloyd Molnar, NP
• Momentum Counseling LLC
• Nicole Monta
• Kelley Ann Montague, RN
• Pierre A Morris, MD
• Movement Matters, Incorporated
• Mark Munir, MD
• Brandt Robert Myer, LLMSW
• Tripti Nagar, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Rochester, MI
• Providers in Rochester, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.