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General NPI Number Information
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NPI Number | 1063564375
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Entity Type | Individual
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Provider Name | RUTH E. MORAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 9105 STONY POINT DR
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City | RICHMOND
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State | VA
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Zip | 23235-1999
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Country | US
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Telephone | 804-521-8713
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Fax | 804-282-6567
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Provider Business Mailing Address
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Address Line | 4540 MOCKERNUT LN
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City | EARLYSVILLE
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State | VA
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Zip | 22936-9698
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Country | US
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Telephone | 434-973-6449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 0101049596
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License Number State | VA
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