Provider Demographics
NPI:1053083220
Name:MORTON, KARON ZAKARIYAH
Entity Type:Individual
Prefix:
First Name:KARON
Middle Name:ZAKARIYAH
Last Name:MORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 NATAHALA DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4303
Mailing Address - Country:US
Mailing Address - Phone:252-676-3691
Mailing Address - Fax:
Practice Address - Street 1:1736 RHODE ISLAND AVE NE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1784
Practice Address - Country:US
Practice Address - Phone:202-798-9826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant