Provider Demographics
NPI:1659672509
Name:MORAH, NNAEMEKA RUFUS (RT(R),(CT))
Entity type:Individual
Prefix:MR
First Name:NNAEMEKA
Middle Name:RUFUS
Last Name:MORAH
Suffix:
Gender:M
Credentials:RT(R),(CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5093 NORIC DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-2575
Mailing Address - Country:US
Mailing Address - Phone:972-266-4366
Mailing Address - Fax:
Practice Address - Street 1:5093 NORIC DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-2575
Practice Address - Country:US
Practice Address - Phone:972-266-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28210247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist