Healthcare Provider Details

I. General information

NPI: 1245232727
Provider Name (Legal Business Name): MICHAEL A MOREHEAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3803 EMERSON AVE
PARKERSBURG WV
26104-1116
US

IV. Provider business mailing address

PO BOX 4179
PARKERSBURG WV
26104-4179
US

V. Phone/Fax

Practice location:
  • Phone: 304-485-5041
  • Fax: 304-485-5678
Mailing address:
  • Phone: 304-485-5041
  • Fax: 304-485-5678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35037384
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number37384
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number10092
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number37384
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number10092
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: