Individual
DR. THEA C. MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, MASTIN BLDG 617, MOBILE, AL 36617-2238
(251) 470-5842
(251) 470-5809
Mailing address
3700 CARLYLE CLOSE, 897, MOBILE, AL 36609-1871
(251) 342-4295
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
20112
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009968275
—
AL
05
—
009968285
—
AL
05
—
06436563
—
MS
05
—
1055883
—
LA
01
—
16-01157
UNITED HEALTH CARE
AL
05
—
271086200
—
FL
01
—
51524024
BLUE CROSS
AL
01
—
51524025
BLUE CROSS
AL
Enumeration date
05/19/2006
Last updated
08/02/2007
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