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Contact Information

MARK E MORAN, PA-C
22890 VIRGIL H GOODE HWY
BOONES MILL, VA24065
 Phone: 540-334-5511
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARK E MORAN · (Male)

NPI Number 1609821677
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 05/24/2006
Last updated 12/08/2025 - About 6 months ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 0110001699
  • VA Medicaid 010010942
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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