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Individual

EDWARD MORAN JR.

Active
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Individual

EDWARD MORAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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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