Provider Demographics
NPI:1023992401
Name:MORRELL, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:MORRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 N 59TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1508
Mailing Address - Country:US
Mailing Address - Phone:414-389-7984
Mailing Address - Fax:
Practice Address - Street 1:3026 N 59TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1508
Practice Address - Country:US
Practice Address - Phone:414-389-7984
Practice Address - Fax:414-389-7984
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program