=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114199270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOREHOUSE SCHOOL OF MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2008
-----------------------------------------------------
Last Update Date | 03/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1150 COLLIER RD NW APT C1
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30318-2929
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-350-6181
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1150 COLLIER RD NW APT C1
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30318-2929
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-350-6181
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OBGYN RESIDENT
-----------------------------------------------------
Name | DR. TRUDY L SEIVWRIGHT
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 404-246-5287
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | MD2008-0066
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------