Provider Demographics
NPI:1467650192
Name:MORRISON, ALAN FAIRCHILD (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:FAIRCHILD
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 49
Mailing Address - Street 2:
Mailing Address - City:MORPETH
Mailing Address - State:ON
Mailing Address - Zip Code:N0P1X0
Mailing Address - Country:CA
Mailing Address - Phone:519-674-1807
Mailing Address - Fax:
Practice Address - Street 1:16001 W 9 MILE RD
Practice Address - Street 2:FAMILY MEDICINE
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-3447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301090258207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine