Provider Demographics
NPI:1447314075
Name:MORCOM MEDICAL CONSULTANTS, PLLC
Entity type:Organization
Organization Name:MORCOM MEDICAL CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-521-0030
Mailing Address - Street 1:235 JENKINS RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28526-9399
Mailing Address - Country:US
Mailing Address - Phone:252-521-0030
Mailing Address - Fax:252-522-3851
Practice Address - Street 1:235 JENKINS RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NC
Practice Address - Zip Code:28526
Practice Address - Country:US
Practice Address - Phone:252-521-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127699207Q00000X, 2084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental DisabilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890257LMedicaid
NC2335762OtherMEDICARE PROVIDER NUMBER