Provider Demographics
NPI:1326110842
Name:MORGAN, HARLEY B (MD)
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 MEDICAL PARK
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-7950
Mailing Address - Fax:803-434-8606
Practice Address - Street 1:NINE MEDICAL PARK
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7950
Practice Address - Fax:803-434-8606
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK17196174400000X
SC32012208000000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC320129Medicaid
SCAA38712389Medicare PIN