Healthcare Provider Details

I. General information

NPI: 1437144557
Provider Name (Legal Business Name): ALAN LEE MORRISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 HOSPITAL DR PATHOLOGY DEPARTMENT
GLEN BURNIE MD
21061-5803
US

IV. Provider business mailing address

301 HOSPITAL DR PATHOLOGY DEPARTMENT
GLEN BURNIE MD
21061-5803
US

V. Phone/Fax

Practice location:
  • Phone: 410-787-4543
  • Fax: 410-595-1991
Mailing address:
  • Phone: 410-787-4543
  • Fax: 410-595-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberD0042419
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD0042419
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: