MEDICARE: MORRISTOWN GASTROENTEROLOGY, P.C

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	207RG0100X	Gastroenterology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982758603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORRISTOWN GASTROENTEROLOGY, P.C

Provider Business Mailing Address
First Line	:	705 N HIGH ST
Second Line	:	SUITE A
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3876
Country	:	US
Telephone Number	:	423-587-0860
Fax Number	:	423-586-1027

Provider Business Practice Location Address
First Line	:	705 N HIGH ST
Second Line	:	SUITE A
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3876
Country	:	US
Telephone Number	:	423-587-0860
Fax Number	:	423-586-1027

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SIVA MARAN
Credential	:	M.D.
Telephone Number	:	423-587-0860

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	04/05/2013

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