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Individual

DR. THOMAS E MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8404 SIEAR TER, 206, INDIANAPOLIS, IN 46227-7215
(317) 889-4120
(317) 889-4128
Mailing address
8404 SIEAR TER, 206, INDIANAPOLIS, IN 46227-7215
(317) 889-4120
(317) 889-4128

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01020493A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083183
ANTHEM PIN
IN
01
011068167A
RAILROAD MEDICARE
05
100060040A
IN
Enumeration date
10/24/2005
Last updated
09/12/2007
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