Edilberto Moreno MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

EDILBERTO MORENO MD PC

Practice address

8384 Holly Rd Ste 2
Grand Blanc, MI 48439-1975

Phone

(810) 344-9073

Fax

(810) 771-4541

NPI assigned

Mar 11, 2020

Last updated

Mar 11, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tammy Lynn Weber

Title

Office Manager

Phone

(810) 344-9073

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1699300582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8384 HOLLY RD STE 2",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391975",
            "telephone_number": "810-344-9073",
            "fax_number": "810-771-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8384 HOLLY RD STE 2",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391975",
            "telephone_number": "810-344-9073",
            "fax_number": "810-771-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDILBERTO MORENO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-344-9073",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.