Provider Demographics
NPI:1639221138
Name:DEAN A MORREL DO
Entity type:Organization
Organization Name:DEAN A MORREL DO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MORREL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:978-534-3500
Mailing Address - Street 1:1069 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-4805
Mailing Address - Country:US
Mailing Address - Phone:978-534-3500
Mailing Address - Fax:
Practice Address - Street 1:1069 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-4805
Practice Address - Country:US
Practice Address - Phone:978-534-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9773851Medicaid
MAJ09286Medicare PIN