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General NPI Number Information
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NPI Number | 1992965065
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Entity Type | Organization
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Legal Business Name | THOMAS H MORACZEWSKI MD
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Dates
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Enumeration Date | 06/12/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 1042 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547
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Country | US
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Telephone | 850-862-5618
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Fax | 850-864-3597
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Provider Business Mailing Address
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Address Line | 1042 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547
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Country | US
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Telephone | 850-862-5618
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Fax | 850-864-3597
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Authorized Official
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Title or Position | INSURANCE
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Name | SHANNON REYNOLDS
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Credential |
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Telephone | 850-862-5618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0042030
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License Number State | FL
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