Provider Demographics
NPI:1730133836
Name:MORGAN, ROSS A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:920 DOUG WHITE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4120
Mailing Address - Country:US
Mailing Address - Phone:843-839-4429
Mailing Address - Fax:843-839-4430
Practice Address - Street 1:920 DOUG WHITE DR STE 150
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4120
Practice Address - Country:US
Practice Address - Phone:843-839-4429
Practice Address - Fax:843-839-4430
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00579512086S0120X
SC518552086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10688OtherBCBS OF FLORIDA
FL063374700Medicaid
FL063374700Medicaid