Provider Demographics
NPI:1558927855
Name:MORAN, DEV'N MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DEV'N
Middle Name:MICHAEL
Last Name:MORAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 ASHLEY RIVER RD APT 4311
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-8724
Mailing Address - Country:US
Mailing Address - Phone:918-728-0201
Mailing Address - Fax:
Practice Address - Street 1:946 ORLEANS RD
Practice Address - Street 2:SUITE B3
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407
Practice Address - Country:US
Practice Address - Phone:843-474-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor