Individual
MR. CHARLES LEO MORAN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
19393 DENBY, REDFORD, MI 48240-1663
(734) 775-3747
Mailing address
19393 DENBY, REDFORD, MI 48240-1663
(734) 775-3747
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704313497
MI
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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