Provider Demographics
NPI:1194741975
Name:MORSE, PATRICK MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:MICHAEL
Last Name:MORSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 W LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9639
Mailing Address - Country:US
Mailing Address - Phone:989-343-1057
Mailing Address - Fax:
Practice Address - Street 1:621 COURT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-8767
Practice Address - Country:US
Practice Address - Phone:989-701-2293
Practice Address - Fax:989-701-2297
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070479207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104416270Medicaid
MI104416270Medicaid