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NPI Code Detail

MEDICARE: MS. MICHELLE THERESA MORAN MD

MEDICARE: MS. MICHELLE THERESA 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
1207Q00000XFamily Medicine Physician36769KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000545891OTHERKYANTHEM
2004163OTHERKYSIHO
3000023029SOTHERKYHUMANA- NORTON
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
59340096OTHERKYCIGNA- NORTON
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
750018435OTHERKYPASSPORT- NORTON CMA
83500224000OTHERKYPASSPORT ADVANTAGE- NORTON CMA- HURSTBOURNE
91902880354OTHERNPI
10200909270OTHERKYMD WISE- NORTON CMA

General Provider Information

NPI Number : 1902880354
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE THERESA MORAN MD
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5116
Provider Business Practice Location Address
First Line : 213 N HURSTBOURNE PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5139
Country : US
Telephone Number : 502-327-5135
Fax Number : 502-327-9475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 04/26/2023

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