Provider Demographics
NPI:1487983680
Name:PATRICK M MORSE MD PC
Entity type:Organization
Organization Name:PATRICK M MORSE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-701-2293
Mailing Address - Street 1:621 COURT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-8767
Mailing Address - Country:US
Mailing Address - Phone:989-701-2293
Mailing Address - Fax:989-701-2297
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070479251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104416270Medicaid
MIH65168Medicare UPIN