Provider Demographics
NPI:1659370716
Name:MORGAN, EDWARD JOSEPH III (PHD, MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOSEPH
Last Name:MORGAN
Suffix:III
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61730
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-1730
Mailing Address - Country:US
Mailing Address - Phone:808-536-7980
Mailing Address - Fax:808-536-7980
Practice Address - Street 1:2046 MOTT-SMITH DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2510
Practice Address - Country:US
Practice Address - Phone:808-536-7980
Practice Address - Fax:808-536-7980
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3576207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04233801Medicaid
HI46763OtherHMSA
HIH0000BDGSWMedicare ID - Type Unspecified
D36394Medicare UPIN