Provider Demographics
NPI:1093976011
Name:MORRIS, MATTHEW W (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:W
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 MEDICAL PARK
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6391
Mailing Address - Country:US
Mailing Address - Phone:304-243-6301
Mailing Address - Fax:304-243-8803
Practice Address - Street 1:30 MEDICAL PARK
Practice Address - Street 2:SUITE 211
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6391
Practice Address - Country:US
Practice Address - Phone:304-243-6301
Practice Address - Fax:304-243-8803
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2012-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV24380208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810021718Medicaid
WVWV0463AMedicare UPIN