Provider Demographics
NPI:1619968153
Name:MOROZOVA, VERA Y (MD)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:Y
Last Name:MOROZOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:1606 N 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2706
Practice Address - Country:US
Practice Address - Phone:812-238-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056729A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200401470Medicaid
INP00760881OtherRR MEDICARE-OAA, LLC
INP00011783OtherRR MEDICARE
IN187440HMedicare PIN
H77016Medicare UPIN
INP00011783OtherRR MEDICARE
IN941090W8Medicare PIN