MEDICARE: GERALD MORLEY PA

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	261QM2500X	Medical Specialty Clinic/Center	18280	MN

General Provider Information

NPI Number	:	1316449457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERALD MORLEY PA

Provider Business Mailing Address
First Line	:	8524 HOPEWOOD LN N
Second Line	:
City	:	NEW HOPE
State	:	MN
Zip	:	55427-1146
Country	:	US
Telephone Number	:	763-587-3260
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 LAKE ROAD AVE
Second Line	:
City	:	ROBBINSDALE
State	:	MN
Zip	:	55422-1800
Country	:	US
Telephone Number	:	763-522-2222
Fax Number	:

Authorized Official
Title or Position	:	NEUROLOGIST
Name	:	GERALD KENT MORLEY
Credential	:	MD
Telephone Number	:	763-587-3260

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	06/16/2018

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