Provider Demographics
NPI:1205805371
Name:MORAN, JOSEPH C (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:MORAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6719 GOVERNOR G C PEERY HIGHWAY
Mailing Address - Street 2:SUITE 3650
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2106
Mailing Address - Country:US
Mailing Address - Phone:276-596-6764
Mailing Address - Fax:276-596-6769
Practice Address - Street 1:6719 GOVERNOR G C PEERY HIGHWAY
Practice Address - Street 2:SUITE 3650
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2106
Practice Address - Country:US
Practice Address - Phone:276-596-6764
Practice Address - Fax:276-596-6769
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101259187208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H89290Medicare UPIN
NC2035147AMedicare ID - Type Unspecified
NC89138EFMedicaid