Healthcare Provider Details

I. General information

NPI: 1205816220
Provider Name (Legal Business Name): STACY L MORRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CCP, LLC, DBA HAND IN HAND PEDIATRICS 6051 MEMORIAL DRIVE
DUBLIN OH
43017
US

IV. Provider business mailing address

CCP, LLC, DBA HAND IN HAND PEDIATRICS 6051 MEMORIAL DRIVE
DUBLIN OH
43017
US

V. Phone/Fax

Practice location:
  • Phone: 614-799-6044
  • Fax: 614-799-6088
Mailing address:
  • Phone: 614-799-6044
  • Fax: 614-799-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35077588M
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: