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General NPI Number Information
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NPI Number | 1205805371
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Entity Type | Individual
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Provider Name | JOSEPH C MORAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 6719 GOVERNOR G C PEERY HIGHWAY SUITE 3650
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City | RICHLANDS
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State | VA
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Zip | 24641-2106
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Country | US
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Telephone | 276-596-6764
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Fax | 276-596-6769
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Provider Business Mailing Address
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Address Line | 6719 GOVERNOR G C PEERY HIGHWAY SUITE 3650
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City | RICHLANDS
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State | VA
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Zip | 24641-2106
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Country | US
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Telephone | 276-596-6764
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Fax | 276-596-6769
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101259187
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License Number State | VA
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