Provider Demographics
NPI:1487647731
Name:MOREHOUSE, DON MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:MICHAEL
Last Name:MOREHOUSE
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:PO BOX 2372
Mailing Address - Street 2:
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-2372
Mailing Address - Country:US
Mailing Address - Phone:954-383-6067
Mailing Address - Fax:815-642-4622
Practice Address - Street 1:5200 N FEDERAL HWY
Practice Address - Street 2:#2-1222
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3253
Practice Address - Country:US
Practice Address - Phone:954-383-6067
Practice Address - Fax:815-642-4622
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8357207L00000X
FLME79836207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038495002Medicaid
TX038495002Medicaid
TXG98258Medicare UPIN