MEDICARE: DR. NIKOLAS ALAN MORING MD

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	208800000X	Urology Physician	78634	MN
2	208800000X	Urology Physician	MD30450	ME

General Provider Information

NPI Number	:	1366079089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKOLAS ALAN MORING MD

Provider Business Mailing Address
First Line	:	PO BOX 860912
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0912
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 HIGH ST
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7676
Country	:	US
Telephone Number	:	207-795-2171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	06/06/2026

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