Individual
EDWARD MORAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
71 WAYNE ST, FORT GAY, WV 25514-8518
(304) 648-5544
Mailing address
P.O. BOX 1680, HUNTINGTON, WV 25717-1680
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22569
WV
208000000X
Pediatrics Physician
22569
WV
208D00000X
General Practice Physician
22569
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001709560
MT. STATE BC/BS
WV
01
—
00767779
RR
WV
05
—
3002119
—
OH
05
—
3810012069
—
WV
05
—
7100061120
—
KY
Enumeration date
05/14/2007
Last updated
05/28/2024
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