Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 2008-00585 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | 2008-00585 | NC |
NPI | 1245451202 |
---|---|
Provider Name | Micah Mooberry |
First Address | Chapel Hill, NC 27599-7035 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 02/04/2021 |