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Individual

EDWARD RICHARD MORAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5959 PARK AVENUE, ST FRANCIS HOSPITAL, MEMPHIS, TN 38119-5198
(901) 432-0173
(901) 854-1585
Mailing address
PO BOX 382927, GERMANTOWN, TN 38188-2927
(901) 432-0173
(901) 854-1585

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD20894
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3076704
TN
01
3126765
BLUE CROSS BLUE SHIELD
Enumeration date
11/08/2006
Last updated
07/08/2007
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