Individual
DR. EDILBERTO A MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 HURLEY PLZ, SUITE 204, FLINT, MI 48503-5903
(810) 239-9444
(810) 239-8729
Mailing address
1316 KINGS POINTE RD, GRAND BLANC, MI 48439-8615
(810) 694-1669
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301051767
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2755365
—
MI
Enumeration date
03/07/2006
Last updated
06/27/2012
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