Organization
MORGAN MEDICAL MANAGEMENT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEMON PARDALES D.O. (PRESIDENT)
(248) 366-9504
Entity
Organization
Contact information
Practice address
2775 BLAKE RD, JACKSON, MI 49201-8838
(517) 787-2906
(517) 787-3039
Mailing address
PO BOX 609, UNION LAKE, MI 48387-0609
(248) 366-9504
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E25632
HEALTH ALLIANCE PLAN
MI
Enumeration date
09/16/2006
Last updated
09/11/2025
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