Provider Demographics
NPI:1013176254
Name:PANSEGRAU, MORGAN LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:LEIGH
Last Name:PANSEGRAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MORGAN
Other - Middle Name:LEIGH
Other - Last Name:GAUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-1100
Mailing Address - Fax:612-727-5972
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:VA OPHTHALMOLOGY
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-1100
Practice Address - Fax:612-727-5972
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6884207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program