Moongang INC

NPI #1437224573 in Fairbanks, Alaska

Provider Information

NPI Number: 1437224573
Entity Type: Organization
Organization Name: Moongang INC
Primary Specialty: Clinic/Center - Urgent Care
Enumeration Date: Nov 22, 2006
Last Updated: Jun 25, 2008

Practice Location

Address: 1867 AIRPORT WAY
Address 2: STE 130B
City: Fairbanks
State: Alaska
ZIP Code: 99701-4056
Phone: (907) 452-2178

Authorized Official

Name: LEONIE HORSTER DERAMUS, MD
Title: PRESIDENT
Phone: (907) 452-2178

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Urgent Care — Urgent Care	261QU0200X	Primary

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