Provider Demographics
NPI:1952361693
Name:MORSON, TRACEY T (MD)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:T
Last Name:MORSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46813 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044
Mailing Address - Country:US
Mailing Address - Phone:586-580-2259
Mailing Address - Fax:586-580-2267
Practice Address - Street 1:46813 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044
Practice Address - Country:US
Practice Address - Phone:586-580-2259
Practice Address - Fax:586-580-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010678382084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4373315Medicaid
MIMI8010001Medicare PIN
MIH39859Medicare UPIN