MEDICARE: DR. MATTHEW TIMOTHY MORAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	95427	SC

General Provider Information

NPI Number	:	1477121721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW TIMOTHY MORAN MD

Provider Business Mailing Address
First Line	:	880 ISLAND PARK DR UNIT 230
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-2902
Country	:	US
Telephone Number	:	843-834-1879
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 ISLAND PARK DR UNIT 220
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-2902
Country	:	US
Telephone Number	:	843-380-9330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	02/26/2026

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