Healthcare Provider Details

I. General information

NPI: 1861403834
Provider Name (Legal Business Name): C. MICHELLE MORGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W. MEMORIAL DR.
HOUGHTON MI
49931
US

IV. Provider business mailing address

901 W. MEMORIAL DR.
HOUGHTON MI
49931
US

V. Phone/Fax

Practice location:
  • Phone: 906-482-9400
  • Fax: 906-483-0269
Mailing address:
  • Phone: 906-482-9400
  • Fax: 906-483-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301060270
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: