Provider Demographics
NPI:1689617987
Name:MORGAN, DENNIS EDWARD (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:EDWARD
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1818 HENDERSON ST
Mailing Address - Street 2:UCI MEDICAL AFFILIATES
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2619
Mailing Address - Country:US
Mailing Address - Phone:803-758-2600
Mailing Address - Fax:803-253-8896
Practice Address - Street 1:10160 DORCHESTER RD
Practice Address - Street 2:DOCTORS CARE
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8527
Practice Address - Country:US
Practice Address - Phone:843-871-7900
Practice Address - Fax:843-871-8731
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC439363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0349PAMedicaid
AA40912514OtherMEDICARE SC
SCP98235Medicare UPIN