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NPI Code Detail

MEDICARE: MICHAEL MORAN

MEDICARE: MICHAEL MORAN
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
1208800000XUrology Physician2017-02511NC

Other Identifiers

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

General Provider Information

NPI Number : 1912957473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MORAN
Provider Business Mailing Address
First Line : PO BOX 743904
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3904
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 720 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3706
Country : US
Telephone Number : 910-642-5832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 05/04/2020

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Directions to “ MICHAEL MORAN ” Practice Location

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