Individual
MARY MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16 FAHEY ST STE 202, BELFAST, ME 04915-6029
(207) 930-6772
(207) 930-6709
Mailing address
16 FAHEY ST STE 202, BELFAST, ME 04915-6029
(207) 930-6772
(207) 930-6709
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036-065620
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-065620
—
IL
Enumeration date
05/22/2006
Last updated
01/11/2016
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