Provider Demographics
NPI:1386640936
Name:MORSE, MARTIN A (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:A
Last Name:MORSE
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2043
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1843
Mailing Address - Country:US
Mailing Address - Phone:703-757-6190
Mailing Address - Fax:703-757-6195
Practice Address - Street 1:8841 E BELL RD STE 201
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1984
Practice Address - Country:US
Practice Address - Phone:703-757-6190
Practice Address - Fax:703-757-6195
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV22100208200000X
CAG-181260208200000X
FLME64773208200000X
VA0101052468208200000X
AZ64531208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7309554Medicaid
VA784430Medicare ID - Type Unspecified
VAG08918Medicare UPIN