Provider Demographics
NPI:1457419582
Name:PAUL, MORGAN A (MD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:A
Last Name:PAUL
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 1:17862 STATE ROUTE 247
Mailing Address - Street 2:
Mailing Address - City:SEAMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45679-9646
Mailing Address - Country:US
Mailing Address - Phone:937-695-0748
Mailing Address - Fax:937-386-0100
Practice Address - Street 1:17862 STATE ROUTE 247
Practice Address - Street 2:
Practice Address - City:SEAMAN
Practice Address - State:OH
Practice Address - Zip Code:45679-9646
Practice Address - Country:US
Practice Address - Phone:937-695-0748
Practice Address - Fax:937-386-0100
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287241207Q00000X
OH35.083922207Q00000X
OHOH35083922P207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV10024031OtherBWC
OH000000652258OtherANTHEM BC/BS
1157198OtherCARELINK
OH2577091Medicaid
OH31091708523OtherCARESOURCE MEDICAID
OH2577091OtherMOLINA MEDICAID
WV3810014397Medicaid
OH8911742OtherCIGNA
OHPA4286721OtherMEDICARE PTAN
OH297011OtherUNISON MEDICAID
OH000000652258OtherANTHEM BC/BS