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Individual

DR. KEVIN MICHAEL MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3802 W KALAMAZOO ST, LANSING, MI 48917-3653
(517) 485-7300
Mailing address
3802 W KALAMAZOO ST, LANSING, MI 48917-3653
(517) 485-7300

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001163
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881660
MI
01
4852310350
BLUE CROSS
MI
Enumeration date
01/19/2007
Last updated
07/08/2007
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