Provider Demographics
NPI:1306950456
Name:MORGAN, SANDRA L (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1701 SOUTH BOULEVARD EAST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-997-5805
Mailing Address - Fax:248-997-5811
Practice Address - Street 1:1701 SOUTH BOULEVARD EAST
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-997-5805
Practice Address - Fax:248-997-5811
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301070881207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4432668Medicaid
MIH72638Medicare UPIN