MEDICARE: EHAB RAGAR EID MORSI MD

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	208000000X	Pediatrics Physician	4301069991	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05274212	OTHER		ECFMG
2	4301069991	OTHER	MI	CONTROLLED SUBSTANCE

General Provider Information

NPI Number	:	1790781383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EHAB RAGAR EID MORSI MD

Provider Business Mailing Address
First Line	:	14600 KING RD
Second Line	:	SUITE A
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7952
Country	:	US
Telephone Number	:	734-479-7800
Fax Number	:	734-479-7802

Provider Business Practice Location Address
First Line	:	14600 KING RD
Second Line	:	SUITE A
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7952
Country	:	US
Telephone Number	:	734-479-7800
Fax Number	:	734-479-7802

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	03/07/2023

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