Provider Demographics
NPI:1366453615
Name:MORGAN, ATHOL W (MD, MHS)
Entity Type:Individual
Prefix:
First Name:ATHOL
Middle Name:W
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD, MHS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5051 GREENSPRING AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209
Mailing Address - Country:US
Mailing Address - Phone:410-601-7790
Mailing Address - Fax:410-601-8704
Practice Address - Street 1:2000 W. BALTIMORE ST
Practice Address - Street 2:CARDIOLOGY DEPT.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223
Practice Address - Country:US
Practice Address - Phone:410-362-3033
Practice Address - Fax:410-362-3437
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD37343207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD76049122Medicaid
MD006701600Medicaid
801LMedicare ID - Type Unspecified
MD006701600Medicaid