Provider Demographics
NPI:1932190840
Name:MORIN, DENIS MARCEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:MARCEL
Last Name:MORIN
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 1:30 BUCHANAN BYP
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:GA
Mailing Address - Zip Code:30113-4924
Mailing Address - Country:US
Mailing Address - Phone:770-646-8281
Mailing Address - Fax:770-646-3579
Practice Address - Street 1:30 BUCHANAN BYP
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:GA
Practice Address - Zip Code:30113-4924
Practice Address - Country:US
Practice Address - Phone:770-646-8281
Practice Address - Fax:770-646-3579
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA02446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA010007539OtherRAILROAD MEDICARE PIN
GA00267286AMedicaid
GAD40703Medicare UPIN
GA00267286AMedicaid