Covenant Family Medicine

NPI #1962532085 in Dacula, Georgia

Provider Information

NPI Number: 1962532085
Entity Type: Organization
Organization Name: Covenant Family Medicine
Primary Specialty: Family Medicine
Enumeration Date: Mar 7, 2007
Last Updated: Jan 15, 2010

Practice Location

Address: 2098 TERON TRACE SUITE 150
City: Dacula
State: Georgia
ZIP Code: 30019
Phone: (678) 730-1620

Authorized Official

Name: DR. HENRY SONG MOON, MD
Title: PARTNER
Phone: (678) 730-1620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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