Provider Demographics
NPI:1851933527
Name:PERIAN, MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:PERIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:GRZEGORZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:4200 WHITEHALL DR STE 130
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9694
Practice Address - Country:US
Practice Address - Phone:734-995-0303
Practice Address - Fax:734-995-0425
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant