Individual
ALICIA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-6137
Mailing address
DEPT CH 17767, PALATINE, IL 60055-7767
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101012899
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101012899
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4162849
—
MI
05
—
4162858
—
MI
05
—
4163668
—
MI
01
—
AM012899
BLUE CROSS BLUE SHIELD
—
01
—
P00098496
RAILROAD MEDICARE
—
Enumeration date
11/23/2005
Last updated
03/06/2008
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