CHARLES B MOOMEY JR MD NPI 1902003841

NPI Information

CHARLES B MOOMEY JR MD is a vascular surgery surgery in Lawrenceville, GA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CHARLES B MOOMEY JR MD NPI is 1902003841. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

631 PROFESSIONAL DRIVE
SUITE 300
LAWRENCEVILLE, GA
ZIP 30046-371
Phone: (770) 962-9977
Fax: (770) 339-9804

The provider's authorized official is Charles Bruce Moomey .
The authorized official title is Owner and has the following contact phone number (770) 962-9977.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 9/1/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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