Individual
MARY MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043750
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C31319
BCBS
MI
01
—
0C313191
BCN
MI
01
—
1200190
PHP
MI
01
—
1270190
COMMERCIAL INSURANCE
MI
01
—
201963697
COMMERCIAL INS
MI
05
—
4711314
—
MI
01
—
5817732
COMMERCIAL
MI
01
—
MM043750
COMMERCIAL
MI
01
—
P58952
BCN
MI
Enumeration date
08/30/2006
Last updated
07/09/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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