Provider Demographics
NPI:1659369874
Name:MORGAN, CORINNE MCMASTER (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:MCMASTER
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 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 130 MEDICAL BUILDING WEST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-8089
Mailing Address - Fax:610-649-2933
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 130 MEDICAL BUILDING WEST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-1175
Practice Address - Fax:610-896-8753
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021695E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009941780001Medicaid
PAD71341Medicare UPIN
PA158569Medicare ID - Type Unspecified