Provider Demographics
NPI:1184692311
Name:MORGAN, TANIA NOELLE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:TANIA
Middle Name:NOELLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 REYNOLDS ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6007
Mailing Address - Country:US
Mailing Address - Phone:912-352-7902
Mailing Address - Fax:912-352-1799
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:SUITE 303
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-352-7902
Practice Address - Fax:912-352-1799
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048172174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7046OtherMEDICARE ID NUMBER
GA000903108CMedicaid
GAGRP7046OtherMEDICARE ID NUMBER