Provider Demographics
NPI:1023022613
Name:MORRIS, RICHARD JOHN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 ELM CREEK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-7073
Mailing Address - Country:US
Mailing Address - Phone:763-420-1010
Mailing Address - Fax:
Practice Address - Street 1:12000 ELM CREEK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7073
Practice Address - Country:US
Practice Address - Phone:763-420-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24015207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN112892200Medicaid
MN106538OtherCHOICE PLUS
MN768936OtherAMERICAS PPO
MNHP11066OtherHEALTHPARTNERS
P00271408OtherRAILROAD MEDICARE
MN101052F031OtherUCARE
0200077OtherMEDICA
MN99D92MOOtherBLUE CROSS AND BLUE SHIEL
MN677940509002OtherPREFERREDONE
MN768936OtherAMERICAS PPO
A95164Medicare UPIN