Individual
MIRANDA NICOLE MORETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-5800
(423) 844-2120
Mailing address
PO BOX 11724, KNOXVILLE, TN 37939-1724
(865) 766-8800
(865) 766-8874
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
46195
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520499
—
TN
Enumeration date
10/11/2007
Last updated
09/13/2016
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