Individual
DR. TIMOTHY JOHN MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 PINE RIDGE BLVD, WAUSAU, WI 54401-4123
(216) 445-2115
Mailing address
425 PINE RIDGE BLVD, WAUSAU, WI 54401-4123
(216) 445-2115
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
51443-20
WI
207L00000X
Anesthesiology Physician
57.009196
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35112300
—
WI
Enumeration date
02/21/2008
Last updated
05/14/2008
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