Basic Information
| Provider Information | |||||||||
| NPI: | 1245597483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | DAVID | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 123 OLD BELDEN HILL RD | ||||||||
| Address2: | UNIT 15 | ||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068501359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034346634 | ||||||||
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| Practice Location | |||||||||
| Address1: | 267 GRANT ST | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066102805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033843000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 05/12/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 053966 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.