Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 20541 | TN |
NPI | 1063502037 |
---|---|
Provider Name | Dr. Michael F Moran |
First Address | Nashville, TN 37203-5180 |
Second Address | Murfreesboro, TN 37129-2567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3702783 | (05) | TN |
6026368 | BCBS (01) | TN |
E92314 | (02) | TN |
Q010444 | (05) | TN |