Healthcare Provider Details

I. General information

NPI: 1952464737
Provider Name (Legal Business Name): ESI MARIE MORGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESI MARIE MORGAN DEWITT

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNETT AVE CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVENUE MLC 4010
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-5203
  • Fax: 513-803-1111
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number35.094011
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: