Healthcare Provider Details

I. General information

NPI: 1477765618
Provider Name (Legal Business Name): LIVINGSTON MEDICAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5865 WHITMORE LAKE ROAD
BRIGHTON MI
48116-1900
US

IV. Provider business mailing address

1203 ARBOR RIDGE DR
BRIGHTON MI
48116-1900
US

V. Phone/Fax

Practice location:
  • Phone: 810-227-1200
  • Fax:
Mailing address:
  • Phone: 810-623-3559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number5101008074
License Number StateMI

VIII. Authorized Official

Name: DR. ROSS JOSEPH MORELL
Title or Position: OWNER
Credential: D.O.
Phone: 810-227-1200