Provider Demographics
NPI:1558558221
Name:VITTORIO M MORREALE MD PLC
Entity type:Organization
Organization Name:VITTORIO M MORREALE MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VITTORIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORREALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-803-1220
Mailing Address - Street 1:50505 SCHOENHERR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3140
Mailing Address - Country:US
Mailing Address - Phone:586-803-1220
Mailing Address - Fax:586-803-1277
Practice Address - Street 1:50505 SCHOENHERR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-3140
Practice Address - Country:US
Practice Address - Phone:586-803-1220
Practice Address - Fax:586-803-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P02560Medicare PIN
MI4492570001Medicare NSC