Individual
DR. ANTONIO MORAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 GLYNCO PKWY STE 35, BRUNSWICK, GA 31525-7930
(912) 304-7013
(912) 342-1025
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
34669
GA
207RX0202X
Medical Oncology Physician
34669
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00471248H
—
GA
01
—
028147
BCBS
GA
Enumeration date
10/25/2005
Last updated
12/29/2022
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