Healthcare Provider Details

I. General information

NPI: 1447854815
Provider Name (Legal Business Name): MIGUEL MORALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 S CLIFF AVE STE 10
SIOUX FALLS SD
57105-1014
US

IV. Provider business mailing address

151 E 4TH PL APT 414
SIOUX FALLS SD
57104-5279
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-3666
  • Fax: 605-322-3665
Mailing address:
  • Phone: 605-322-3665
  • Fax: 605-322-3665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number18463
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: