Provider Demographics
NPI:1316107295
Name:MORAN, TIMOTHY PAUL (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PAUL
Last Name:MORAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:333 S COLUMBIA ST
Mailing Address - Street 2:CB# 7231
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-962-5136
Mailing Address - Fax:919-962-4421
Practice Address - Street 1:333 S COLUMBIA ST
Practice Address - Street 2:CB# 7231
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-962-5136
Practice Address - Fax:919-962-4421
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2015-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-000482080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
86564UMedicare UPIN