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General NPI Number Information
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NPI Number | 1811881071
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Entity Type | Individual
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Provider Name | LOGAN MICHAEL MORREY MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1301 N COLUMBIA RD STOP 9037
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City | GRAND FORKS
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State | ND
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Zip | 58202-9037
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Country | US
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Telephone | 701-777-2514
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Fax |
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Provider Business Mailing Address
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Address Line | 414 18TH ST N
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City | MOORHEAD
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State | MN
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Zip | 56560-2367
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Country | US
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Telephone | 507-269-6871
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 22681
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License Number State | ND
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