Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 33098 | WI |
NPI | 1013024421 |
---|---|
Provider Name | Dr. James T Moran |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Burlington, WI 53105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 28/07/2011 |