Healthcare Provider Details

I. General information

NPI: 1770902470
Provider Name (Legal Business Name): MICHAEL MORHOUS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 08/09/2024
Certification Date: 08/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 BRIDGEHAMPTON-SAG HARBOR TPKE SUITE C
BRIDGEHAMPTON NY
11932
US

IV. Provider business mailing address

26 HILL ST # 234
SOUTHAMPTON NY
11968-5317
US

V. Phone/Fax

Practice location:
  • Phone: 917-765-6989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number291409
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number291409
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: