=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114307352
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GAYBRIEL MORRELL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2015
-----------------------------------------------------
Last Update Date | 03/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27155 CHERRY HILL RD
-----------------------------------------------------
City | INKSTER
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48141-1204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-749-1178
-----------------------------------------------------
Fax | 313-733-2029
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 746723
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30374-6723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-733-9730
-----------------------------------------------------
Fax | 773-866-8014
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 4301107231
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------