Provider Demographics
NPI:1366935728
Name:FERRUZZI, MORGAN ELIZABETH MARIE (MD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH MARIE
Last Name:FERRUZZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10816 BLACK DOG LN STE 160
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-1479
Practice Address - Country:US
Practice Address - Phone:704-316-3970
Practice Address - Fax:704-316-3971
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC239129390200000X
NC2021-01976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program