Organization
MICHELLE MORAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE RUTH MORAN M.D. (PRESIDENT)
(719) 328-9653
Entity
Organization
Contact information
Practice address
716 N TEJON ST, STE 4, COLORADO SPRINGS, CO 80903-1012
(719) 328-9653
(719) 328-9738
Mailing address
PO BOX 38969, COLORADO SPRINGS, CO 80937-8969
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
MD 39135
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10686045
—
CO
Enumeration date
11/18/2007
Last updated
11/20/2007
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