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Individual

ANTOINETTE MARIE MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
420 DELAWARE ST SE, MMC 404, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6777
Mailing address
420 DELAWARE ST SE, MMC 404, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6777

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
31322
MN
2080P0205X
Pediatric Endocrinology Physician
Primary
31322
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0051748
MT
01
0246157
OH MA
OH
05
0963157
IA
01
1009249
PREFERRED ONE
01
100925
UCARE
01
24534
ARAZ/PPO
01
2T300MO
BCBS
MN
05
31504800
WI
01
3324983
MEDICA CHOICE
01
3374526
MEDICA PRIMARY
05
706594700
MN
01
HP 21999
HEALTHPARTNERS
Enumeration date
07/10/2006
Last updated
07/05/2016
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