Healthcare Provider Details

I. General information

NPI: 1497252621
Provider Name (Legal Business Name): MICHAEL WESLEY MORRISON CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

1392 SLATE CT
CLEVELAND OH
44118-1479
US

V. Phone/Fax

Practice location:
  • Phone: 704-616-9278
  • Fax:
Mailing address:
  • Phone: 704-616-9278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number143199
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: