Healthcare Provider Details

I. General information

NPI: 1538127865
Provider Name (Legal Business Name): PETER CHARLES MORAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 MAPLE ST STE 210
GILFORD NH
03249-6580
US

IV. Provider business mailing address

250 PLEASANT ST
CONCORD NH
03301-2598
US

V. Phone/Fax

Practice location:
  • Phone: 603-527-7114
  • Fax:
Mailing address:
  • Phone: 603-227-7000
  • Fax: 603-353-0412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13072
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: