Individual
DR. STEPHAN G. MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 SIVLEY RD SW, SUITE 400, HUNTSVILLE, AL 35801-5134
(256) 265-2895
(256) 265-9777
Mailing address
PO BOX 2705, HUNTSVILLE, AL 35804-2705
(256) 265-4595
(256) 265-4599
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
00021195
AL
2086S0127X
Trauma Surgery Physician
00021195
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009947965
—
AL
01
—
051520526
BCBS
AL
05
—
4046898
—
TN
01
—
4086146
BCBS
TN
Enumeration date
02/21/2006
Last updated
07/22/2015
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