Healthcare Provider Details

I. General information

NPI: 1184626376
Provider Name (Legal Business Name): BRIAN G MORLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GYPSY LN
YOUNGSTOWN OH
44504-1315
US

IV. Provider business mailing address

PO BOX 49
PITTSBURGH PA
15230-0049
US

V. Phone/Fax

Practice location:
  • Phone: 330-884-3374
  • Fax: 330-884-5789
Mailing address:
  • Phone: 412-937-5949
  • Fax: 412-937-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number35081952M
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: