Healthcare Provider Details

I. General information

NPI: 1356418594
Provider Name (Legal Business Name): RICHARD EUGENE MORAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 CALDWELL RD
AUGUSTA ME
04345
US

IV. Provider business mailing address

16 CALDWELL RD
AUGUSTA ME
04345
US

V. Phone/Fax

Practice location:
  • Phone: 207-621-4116
  • Fax: 207-622-4085
Mailing address:
  • Phone: 207-621-4116
  • Fax: 207-622-4085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number014806
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: