Charles B Moomey Jr MD

NPI #1902003841 in Lawrenceville, Georgia

Provider Information

NPI Number: 1902003841
Entity Type: Organization
Organization Name: Charles B Moomey Jr MD
Primary Specialty: Surgery - Vascular Surgery
Enumeration Date: Jul 2, 2007
Last Updated: Sep 1, 2010

Practice Location

Address: 631 PROFESSIONAL DRIVE
Address 2: SUITE 300
City: Lawrenceville
State: Georgia
ZIP Code: 30046-3371
Phone: (770) 962-9977

Authorized Official

Name: CHARLES BRUCE MOOMEY JR., M.D.
Title: OWNER
Phone: (770) 962-9977

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery - Vascular Surgery — Vascular Surgery	2086S0129X	Primary

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