Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 21688 | NC |
N | 207QA0401X | Family Doctor - Addiction Medicine | 21688 | NC |
NPI | 1245371897 |
---|---|
Provider Name | Dr. Al J Mooney III |
First Address | Cary, NC 27513-5586 |
Second Address | Cary, NC 27513-5586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |