Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 5101011284 | MI |
Y | 208600000X | Surgeon | 5101011284 | MI |
NPI | 1003925033 |
---|---|
Provider Name | Dawn Elaine Morey |
First Address | Port Huron, MI 48061-0669 |
Second Address | Port Huron, MI 48060-6589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 07/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4844446 | (05) | MI |
G51538 | (02) |