Healthcare Provider Details

I. General information

NPI: 1609371434
Provider Name (Legal Business Name): CHRISTOPHER E MOREAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2018
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

748 GRANT ST
IOWA CITY IA
52240-6228
US

V. Phone/Fax

Practice location:
  • Phone: 319-353-6963
  • Fax: 319-356-2587
Mailing address:
  • Phone: 570-713-7662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD-49566
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-49566
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: