Provider Demographics
NPI:1629359104
Name:MORGAN, MICHELLE JIMENEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JIMENEZ
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6628 CROSSBOW CT
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-7203
Mailing Address - Country:US
Mailing Address - Phone:440-237-8182
Mailing Address - Fax:
Practice Address - Street 1:6628 CROSSBOW CT
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-7203
Practice Address - Country:US
Practice Address - Phone:440-237-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-063623207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology