Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 80205 | GA |
N | 2086S0120X | Pediatric Surgery | M-15272 | ID |
NPI | 1184948739 |
---|---|
Provider Name | Morgan Richards |
First Address | Seattle, WA 98117-6152 |
Second Address | Atlanta, GA 30322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2010 |
Last Update Date | 13/04/2021 |