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Individual

DR. JOHN A MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1542 GOLF COURSE RD, SUITE 201, GRAND RAPIDS, MN 55744
(218) 326-3433
(218) 326-3435
Mailing address
1542 GOLF COURSE RD, SUITE 201, GRAND RAPIDS, MN 55744
(218) 326-3433
(218) 326-3435

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20816
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180001387
INDIVIDUAL MEDICARE NUMBER GRAND RAPIDS
MN
01
180001388
INDIVIDUAL MEDICARE NUMBER HIBBING
MN
01
C02738
MEDICARE PROVIDER NUMBER HIBBING
MN
01
C08247
MEDICARE GRAND RAPIDS PROVIDER NUMBER
MN
Enumeration date
08/24/2005
Last updated
01/07/2010
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