Provider Demographics
NPI:1538160908
Name:GALES, MORRIS EDWARD III (MD, CWS, FCCWS)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:EDWARD
Last Name:GALES
Suffix:III
Gender:M
Credentials:MD, CWS, FCCWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 SW 160TH AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-6314
Mailing Address - Country:US
Mailing Address - Phone:877-866-7123
Mailing Address - Fax:
Practice Address - Street 1:3601 SW 160TH AVE STE 250
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6314
Practice Address - Country:US
Practice Address - Phone:877-866-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049444208600000X, 208D00000X
FLME129562208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP50224OtherBLUE CARE NETWORK
MI75104AOtherHEALTH ALLIANCE PLAN
MI2627623-10Medicaid
MIDR630043OtherMCARE
MI020029253OtherMEDICARE TRAVELERS
MI0206347852OtherBCBS
MI4786290-10Medicaid
MIE33532Medicare UPIN
MI2627623-10Medicaid
MI0N23600001Medicare PIN
MI020029253OtherMEDICARE TRAVELERS