MEDICARE: MORGAN M EWALD PA-S

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	363A00000X	Physician Assistant	5601013765	MI

General Provider Information

NPI Number	:	1760255848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN M EWALD PA-S

Provider Business Mailing Address
First Line	:	33333 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3312
Country	:	US
Telephone Number	:	248-880-7577
Fax Number	:

Provider Business Practice Location Address
First Line	:	33333 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3312
Country	:	US
Telephone Number	:	248-880-7757
Fax Number	:

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

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	01/26/2026

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