Healthcare Provider Details

I. General information

NPI: 1265427330
Provider Name (Legal Business Name): MELVIN L MORSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 FEDERAL ST SUITE 3
MILTON DE
19968-1115
US

IV. Provider business mailing address

611 FEDERAL ST SUITE 3
MILTON DE
19968-1115
US

V. Phone/Fax

Practice location:
  • Phone: 302-684-1119
  • Fax: 302-329-9234
Mailing address:
  • Phone: 302-684-1119
  • Fax: 302-329-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0008267
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD00019734
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: