Provider Demographics
NPI:1558355651
Name:MORAN, JON F (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:F
Last Name:MORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:115 HEART DR DEPT OF
Practice Address - Street 2:ECU PHYSICIANS CARDIOLOGY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8944
Practice Address - Country:US
Practice Address - Phone:252-744-4400
Practice Address - Fax:252-744-3987
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2011-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9500159208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8960567Medicaid
NC60567OtherBCBS NC
NC330004171OtherRAILROAD MEDICARE
NCC51843Medicare UPIN
NC8960567Medicaid