Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 200400558 | NC |
NPI | 1275535072 |
---|---|
Provider Name | Dr. Mark Wayne Morgan |
First Address | Wilmington, NC 28403-1473 |
Second Address | Wilmington, NC 28401-7300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I16093 | (02) | NC |