Provider Demographics
NPI:1477603587
Name:MORRIS E. GALES III MD
Entity Type:Organization
Organization Name:MORRIS E. GALES III MD
Other - Org Name:WOUND CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GALES
Authorized Official - Suffix:III
Authorized Official - Credentials:MD,FCCWS
Authorized Official - Phone:248-423-1550
Mailing Address - Street 1:29556 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2021
Mailing Address - Country:US
Mailing Address - Phone:248-423-1550
Mailing Address - Fax:248-423-1552
Practice Address - Street 1:29556 SOUTHFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2021
Practice Address - Country:US
Practice Address - Phone:248-423-1550
Practice Address - Fax:248-423-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2014-02-26
Deactivation Date:2008-11-11
Deactivation Code:
Reactivation Date:2014-02-26
Provider Licenses
StateLicense IDTaxonomies
MI4301049444208D00000X
MI4704114991363L00000X
MI4704207635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N99340Medicare PIN
MI0N23600Medicare PIN
MI0N23590Medicare PIN
MI0N99350Medicare PIN