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General NPI Number Information
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NPI Number | 1124004650
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Entity Type | Organization
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Legal Business Name | PETER C MORAN MD
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 350 MAIN ST STE 3
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City | HAVERHILL
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State | MA
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Zip | 01830-4023
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Country | US
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Telephone | 978-521-0900
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Fax | 978-521-3335
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Provider Business Mailing Address
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Address Line | 350 MAIN ST STE 3
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City | HAVERHILL
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State | MA
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Zip | 01830-4023
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Country | US
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Telephone | 978-521-0900
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Fax | 978-521-3335
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Authorized Official
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Title or Position | DOCTOR
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Name | PETER MORAN
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Credential | MD
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Telephone | 978-521-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 60311
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License Number State | MA
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