CHUL SO MOON (NPI# 1316999055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316999055 |
| Entity Type | Individual |
| Full Name | CHUL SO MOON |
| Credential | MD |
| Practice Address |
87 Mcgregor St Manchester NH 03102-3765 |
| Practice Telephone | 6036291828 |
| Mailing Telephone | 6036291828 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
20654 | NH | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
LT4202 | NH | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
27463 | OK | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
MD442671 | PA | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
D54806 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 699108400 | 05 |
| Street Address |
87 MCGREGOR ST |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03102-3765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851397442 | Stephen I Bogursky | Anesthesiology | 87 Mcgregor St, Ste. 1400, Manchester, NH 03102-3731 | 2005-06-28 |
| 1942721162 | Elizabeth Ashley Katsikides | Nurse Practitioner | 87 Mcgregor St, Manchester, NH 03102-3765 | 2017-06-28 |
| 1154794261 | Ap Derm New Hampshire PC | Dermatology | 87 Mcgregor St, Suite 2100, Manchester, NH 03102-3765 | 2015-11-11 |
| 1235508227 | Andrea F Bonenfant | Nurse Practitioner | 87 Mcgregor St, Manchester, NH 03102-3765 | 2015-09-19 |
| 1891172557 | Andrew M Slater | Internal Medicine | 87 Mcgregor St, Manchester, NH 03102 | 2015-05-01 |
| 1033501564 | Kristen Elizabeth Newell | Registered Nurse | 87 Mcgregor St, Manchester, NH 03102-3765 | 2015-02-20 |
| 1699180208 | Jennifer Rioux | Nurse Practitioner | 87 Mcgregor St, Ste. 3200, Manchester, NH 03102-3765 | 2014-06-23 |
| 1124451380 | Margaret Mary Crowder | Nurse Practitioner | 87 Mcgregor St, Suite 3200, Manchester, NH 03102-3765 | 2013-08-12 |
| 1447682257 | Meaghan O'leary | Nurse Practitioner | 87 Mcgregor St, Suite 3100, Manchester, NH 03102-3765 | 2013-08-02 |
| 1508170820 | Eric Hyman Grover | Psychiatry & Neurology | 87 Mcgregor St, Manchester, NH 03102-3765 | 2010-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366054249 | Aaa Home Health LLC | Home Health | 30 Greenview Drive Apt 33, Manchester, NH 03102 | 2020-08-20 |
| 1043790413 | Sabrina Bolianites | Family Medicine | 765 S Main St Ste 103, Manchester, NH 03102 | 2018-08-15 |
| 1184119869 | Allison Marie Doherty | Doula | 17 Davignon St, Manchester, NH 03102 | 2018-06-26 |
| 1215311345 | Families In Transition | Counselor | 307 Douglas St, Manchester, NH 03102 | 2015-07-18 |
| 1659626836 | Steven Allen Miller | Nurse Anesthetist, Certified Registered | 88 Mcgregor St Ste 303, Manchester, NH 03102 | 2012-07-13 |
| 1922381144 | Caroline Ilene Ball | Pharmacist | 227 South Main Street, Manchester, NH 03102 | 2011-09-23 |
| 1225343346 | Peter Rella | Pharmacist | 577 Mast Road, Manchester, NH 03102 | 2010-08-12 |
| 1528206042 | Michael E. Dobrowolski Od,pa | Optometrist | 395 So Main Street, Manchester, NH 03102 | 2009-01-22 |
| 1912153487 | Nilsa Marie Jimenez | Internal Medicine | 775 S Main Street, Queen City Medical Associates, Manchester, NH 03102 | 2008-08-14 |
| 1871758060 | Samuel Joffe | Internal Medicine | 100 Mcgregor St Fl B, Manchester, NH 03102 | 2008-07-28 |
| Find all providers in zip 03102 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346223385 | Gabriele Southgate | Internal Medicine | 87 Mcgregor Street, Hematology/oncology, Manchester, NH 03102 | 2005-11-23 |
| 1003801689 | Utpal K Bhanja | Internal Medicine | 515 Memorial Dr Ste 1, Manchester, KY 40962-9157 | 2005-09-20 |
| 1801946652 | Karen Jane Hoffmeister | Internal Medicine | 100 Hitchcock Way, Manchester, NH 03104 | 2007-01-12 |
| 1225045636 | Medical Oncology and Blood Disorders, LLP | Internal Medicine | 100 Haynes St Fl 2, Dequattro Community Cancer Center, Manchester, CT 06040-4113 | 2006-08-01 |
| 1033153374 | Goran Broketa | Internal Medicine | 718 Smyth Rd, Manchester, NH 03104-7007 | 2006-06-16 |
| 1386697803 | Dartmouth-hitchcock Clinic | Internal Medicine | 100 Hitchcock Way, Manchester, NH 03104-4125 | 2006-05-18 |
| 1265426035 | Eric M Bonnem | Internal Medicine | 87 Mcgregor St, Dartmouth Hitchcock - Hematology/oncology, Manchester, NH 03102 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568622801 | Yoko Fukuda | Internal Medicine | 155 Borthwick Ave Ste C, Portsmouth, NH 03801-7156 | 2008-06-10 |
| 1063470011 | Zachary S Spigelman | Internal Medicine | 6 Tsienneto Rd Ste 204, Derry, NH 03038-1584 | 2006-05-01 |
| 1356302822 | Nancy S Chun | Internal Medicine | 10 Prospect St., Second Floor, Nashua, NH 03060 | 2006-03-31 |
| 1831175314 | John Posner | Internal Medicine | 166 Kinsley St, Nashua, NH 03060-3676 | 2005-12-16 |
| 1710971684 | Douglas J Weckstein | Internal Medicine | 200 Technology Dr, Hooksett, NH 03106-2504 | 2005-09-07 |
| 1649271438 | Phillip Joseph Manno | Internal Medicine | 172 Kinsley St, Nashua, NH 03060-3648 | 2005-08-03 |
| 1033523733 | Bhavina Batukbhai Sharma | Internal Medicine | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2014-06-20 |
| 1568803971 | Sivraj Muralikrishnan | Internal Medicine | 2300 Southwood Dr, Nashua, NH 03063 | 2013-07-13 |
| 1699119842 | Garrett Thomas Wasp | Internal Medicine | One Medical Center Dr, Hematology/oncology, Lebanon, NH 03756-0001 | 2013-04-18 |
| 1578705307 | Oncology Center | Internal Medicine | 172 Kinsley St, Nashua, NH 03060-3648 | 2009-03-25 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 03102 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.