Healthcare Provider Details

I. General information

NPI: 1831178649
Provider Name (Legal Business Name): W. MICHAEL MORRISSEY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 W BROAD ST STE 170
BETHLEHEM PA
18018-5738
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-1260
  • Fax:
Mailing address:
  • Phone: 484-526-1260
  • Fax: 610-838-7669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD058803L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD058803L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: