Healthcare Provider Details

I. General information

NPI: 1922070671
Provider Name (Legal Business Name): PATRICK MONTAGUE MORGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 W PALMETTO ST
FLORENCE SC
29501-5935
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-6870
  • Fax: 843-777-6871
Mailing address:
  • Phone: 843-777-6870
  • Fax: 843-777-6871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20512
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: