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Individual

DAVID JOHN MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10215 AUBURN PARK DR, FORT WAYNE, IN 46825-2387
(260) 234-5400
(317) 968-1475
Mailing address
10215 AUBURN PARK DR, FORT WAYNE, IN 46825-2387
(260) 234-5400
(317) 968-1475

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01044168A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000595587
ANTHEM
IN
05
200150750
IN
01
P00698427
MEDICARE RR
IN
Enumeration date
08/21/2006
Last updated
05/16/2025
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