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Individual

DR. MICHAEL C MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1802 S. MATTIS AVENUE, ORTHOPEDICS, CHAMPAIGN, IL 61821
(217) 383-7676
(217) 383-4910
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
(217) 383-4752

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036084080
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036084080
IL
Enumeration date
05/17/2006
Last updated
05/07/2014
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