Provider Demographics
NPI:1740202183
Name:MORGAN, ANNE E (DDS, MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:E
Other - Last Name:MORGAN-MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MD
Mailing Address - Street 1:5837 HARBOUR VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2657
Mailing Address - Country:US
Mailing Address - Phone:757-686-2703
Mailing Address - Fax:757-686-3737
Practice Address - Street 1:5837 HARBOUR VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2657
Practice Address - Country:US
Practice Address - Phone:757-686-2703
Practice Address - Fax:757-686-3737
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014100771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV07402Medicare UPIN
V07402Medicare UPIN
VA190001375Medicare ID - Type Unspecified