Healthcare Provider Details

I. General information

NPI: 1801804968
Provider Name (Legal Business Name): ERIC DALTON MORSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 HEALTH PARK CAROLINA PERFORMANCE - SUITE 201
RALEIGH NC
27615
US

IV. Provider business mailing address

1225 N BLOUNT ST
RALEIGH NC
27604-1459
US

V. Phone/Fax

Practice location:
  • Phone: 919-673-9681
  • Fax:
Mailing address:
  • Phone: 919-673-9681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number0099-01445
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: