MEDICARE: DR. PHILIP J MORREALE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	00423	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104810928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP J MORREALE DPM

Provider Business Mailing Address
First Line	:	4508 CHADWICK RD
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-7958
Country	:	US
Telephone Number	:	319-277-4508
Fax Number	:	319-277-8908

Provider Business Practice Location Address
First Line	:	4508 CHADWICK RD
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-7958
Country	:	US
Telephone Number	:	319-277-4508
Fax Number	:	319-277-8908

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	06/21/2012

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