Provider Demographics
NPI:1962469379
Name:MORGAN, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:72 HIGHLAND AVENUE
Mailing Address - Street 2:PEDIATRIC ASSOCIATES OF GREATER SALEM
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-745-3050
Mailing Address - Fax:978-745-7014
Practice Address - Street 1:72 HIGHLAND AVENUE
Practice Address - Street 2:PEDIATRIC ASSOCIATES OF GREATER SALEM
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-745-3050
Practice Address - Fax:978-745-7014
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2012-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA210294208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
210294OtherTUFTS
MA0157791Medicaid
J23708OtherBS
MA0157791Medicaid
210294OtherTUFTS