Moretz, Miranda Nicole

Moretz, Miranda Nicole is an individual health care provider with primary practice located at 1 Medical Park Blvd , Bristol TN 37620-7430. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Moretz, Miranda Nicole can be contacted via phone (423) 844-5800.

Contact Information

Primary practice address
1 Medical Park Blvd Bristol TN 37620-7430
Phone: (423) 844-5800
Fax: (423) 844-2120
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 46195 Tennessee

Profile Details

NPI number 1255529509
LBN Legal business name Moretz, Miranda Nicole
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2007
Last updated Sep 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1255529509 NPPES
Tennessee MEDICAID 1520499

Popular Providers