MEDICARE: DR. RONALD L MORSE D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	5901001110	MI

General Provider Information

NPI Number	:	1144377979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD L MORSE D.P.M.

Provider Business Mailing Address
First Line	:	13736 HIDDEN ACRES DR
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424-8105
Country	:	US
Telephone Number	:	616-396-5717
Fax Number	:

Provider Business Practice Location Address
First Line	:	334 WASHINGTON BLVD
Second Line	:	APT # 2
City	:	HOLLAND
State	:	MI
Zip	:	49423-3328
Country	:	US
Telephone Number	:	616-396-5717
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/08/2007

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