Provider Demographics
NPI:1760489942
Name:MORELLI, MICHAEL SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SAMUEL
Last Name:MORELLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8051 SOUTH EMERSON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8632
Mailing Address - Country:US
Mailing Address - Phone:317-865-2955
Mailing Address - Fax:317-865-2944
Practice Address - Street 1:8051 SOUTH EMERSON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8632
Practice Address - Country:US
Practice Address - Phone:317-865-2955
Practice Address - Fax:317-865-2944
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2020-03-09
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Provider Licenses
StateLicense IDTaxonomies
IN01058426A207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200121410Medicaid
IN200121410Medicaid
H11980Medicare UPIN
IN066980SMedicare PIN
INH11980Medicare UPIN