Healthcare Provider Details

I. General information

NPI: 1447314075
Provider Name (Legal Business Name): MORCOM MEDICAL CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 JENKINS RD
DOVER NC
28526
US

IV. Provider business mailing address

235 JENKINS RD
DOVER NC
28526-9399
US

V. Phone/Fax

Practice location:
  • Phone: 252-521-0030
  • Fax:
Mailing address:
  • Phone: 252-521-0030
  • Fax: 252-522-3851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number127699
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number127699
License Number StateNC

VIII. Authorized Official

Name: DAWN R MOORE
Title or Position: ADMINISTRATIVE OFFICER
Credential:
Phone: 252-521-0030