Provider Demographics
NPI:1225109721
Name:MORSE, DONNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TIDEWATER COLONY DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2592
Mailing Address - Country:US
Mailing Address - Phone:410-266-8010
Mailing Address - Fax:443-782-2498
Practice Address - Street 1:2001 TIDEWATER COLONY DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2592
Practice Address - Country:US
Practice Address - Phone:410-266-8010
Practice Address - Fax:443-782-2498
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407282100Medicaid
MDS4410002OtherCAREFIRST BLUE CHOICE
MD6400548OtherUNITED HEALTH CARE
MD35033511OtherCAREFIRST BS
MD1406818OtherCIGNA HEALTH CARE
MD4276108OtherAETNA
MDS4410002OtherCAREFIRST BLUE CHOICE
MD4276108OtherAETNA