Individual
MR. GREGORY MARK MORELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2206 22ND ST, NITRO, WV 25143-1729
(304) 755-1571
(304) 755-3091
Mailing address
2206 22ND ST, NITRO, WV 25143-1729
(304) 755-1571
(304) 755-3091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14373
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052030000
—
WV
Enumeration date
01/23/2006
Last updated
03/07/2008
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