Provider Demographics
NPI:1982704409
Name:MORGAN, ANN MICHELE (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:A.
Other - Middle Name:MICHELE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3030 N CENTRAL AVE STE 1001
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2716
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:500 W THOMAS RD STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4245
Practice Address - Country:US
Practice Address - Phone:602-406-9999
Practice Address - Fax:602-406-8099
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43014071752084P0800X
AZ369362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ316151Medicaid
MI0827409OtherBLUE CROSS BLUE SHIELD
AZZ126367Medicare PIN
AZZ126368Medicare PIN
AZ316151Medicaid
MI0827409OtherBLUE CROSS BLUE SHIELD