Provider Demographics
NPI:1669091328
Name:MORGAN, MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH STREET
Mailing Address - Street 2:WARRINER 1, DEPT OF PSYCHIATRY
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-395-7513
Mailing Address - Fax:413-346-6733
Practice Address - Street 1:725 NORTH STREET
Practice Address - Street 2:WARRINER 1, DEPT OF PSYCHIATRY
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-395-7513
Practice Address - Fax:413-346-6733
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-07-07
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-01-25
Provider Licenses
StateLicense IDTaxonomies
MA2855152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry