Provider Demographics
NPI:1023026622
Name:MORAN, MARK G (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:G
Last Name:MORAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:520 MEDICAL CENTER DRIVE
Mailing Address - Street 2:STE 200
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4314
Mailing Address - Country:US
Mailing Address - Phone:541-930-7222
Mailing Address - Fax:541-930-7220
Practice Address - Street 1:520 MEDICAL CENTER DRIVE
Practice Address - Street 2:STE 200
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4314
Practice Address - Country:US
Practice Address - Phone:541-282-6606
Practice Address - Fax:541-282-6601
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-11-14
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Provider Licenses
StateLicense IDTaxonomies
ORMD12774207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease