Provider Demographics
NPI:1396786661
Name:MORAND, THOMAS M (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:MORAND
Suffix:
Gender:M
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:P.O. BOX 636745
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6745
Mailing Address - Country:US
Mailing Address - Phone:513-451-4033
Mailing Address - Fax:513-451-4118
Practice Address - Street 1:2452 KIPLING ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239
Practice Address - Country:US
Practice Address - Phone:513-451-4033
Practice Address - Fax:513-451-4033
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350441522085R0001X
OH35-04-41522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0489458Medicaid
OH0489458Medicaid
OHA80404Medicare UPIN
A80404Medicare UPIN
OH4303931Medicare PIN
OH0515798Medicare PIN
0515795Medicare PIN