Healthcare Provider Details

I. General information

NPI: 1154380319
Provider Name (Legal Business Name): MICHAEL J MORAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W UNIVERSITY AVE SUITE 300
MUNCIE IN
47303-3400
US

IV. Provider business mailing address

1200 W WHITE RIVER BLVD STE 300
MUNCIE IN
47303-4988
US

V. Phone/Fax

Practice location:
  • Phone: 765-281-2000
  • Fax: 765-281-2062
Mailing address:
  • Phone: 877-668-5621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number01037770A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01037770A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: