MEDICARE: THOMAS E MORAN MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	011068167A	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235128216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS E MORAN MD INC

Provider Business Mailing Address
First Line	:	8404 SIEAR TER
Second Line	:	STE 101
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7201
Country	:	US
Telephone Number	:	317-848-4120
Fax Number	:	317-848-4128

Provider Business Practice Location Address
First Line	:	8404 SIEAR TER
Second Line	:	STE 101
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-7201
Country	:	US
Telephone Number	:	317-848-4120
Fax Number	:	317-848-4128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS E MORAN
Credential	:	M.D.
Telephone Number	:	317-889-4120

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	11/01/2011

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