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General NPI Number Information
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NPI Number | 1265407324
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Entity Type | Individual
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Provider Name | MICHAEL C MORIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 13 LEISURE LN
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City | GRANITE FALLS
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State | NC
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Zip | 28630-9321
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Country | US
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Telephone | 912-266-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 13 LEISURE LN
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City | GRANITE FALLS
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State | NC
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Zip | 28630-9321
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Country | US
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Telephone | 912-266-4479
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 049147
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2007-01611
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License Number State | NC
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