Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 23622 | NC |
NPI | 1104802164 |
---|---|
Provider Name | Dr. Joel Clarence Morgan |
First Address | Charlotte, NC 28260-0447 |
Second Address | Winston Salem, NC 27104-3770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 04/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1104802164 | (05) | VA |
8960729 | (05) | NC |
C82039 | (02) |