Healthcare Provider Details

I. General information

NPI: 1811988280
Provider Name (Legal Business Name): DAVID PETER MORIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NEW DRIFTWAY SUITE 201
SCITUATE MA
02066-4530
US

IV. Provider business mailing address

10 NEW DRIFTWAY SUITE 201
SCITUATE MA
02066-4530
US

V. Phone/Fax

Practice location:
  • Phone: 781-545-9225
  • Fax: 781-545-8560
Mailing address:
  • Phone: 781-545-9225
  • Fax: 781-545-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number46516
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier201072
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerHPHC
# 2
IdentifierO155819
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer
# 3
Identifier456192
Identifier TypeOTHER
Identifier State
Identifier IssuerTUFTS USFHP
# 4
Identifier705739
Identifier TypeOTHER
Identifier State
Identifier IssuerTUFTS
# 5
Identifier3552817
Identifier TypeOTHER
Identifier State
Identifier IssuerCIGNA
# 6
IdentifierMOJ23021
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerBCBS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: