Provider Demographics
NPI:1235680224
Name:STEELE-MORRIS, CHARLOTTE JOY ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE JOY
Middle Name:ALEXANDRA
Last Name:STEELE-MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 FERNLEAF DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-2180
Mailing Address - Country:US
Mailing Address - Phone:765-494-8588
Mailing Address - Fax:
Practice Address - Street 1:715 CLINIC DR
Practice Address - Street 2:PURDUE UNIVERSITY, LYLES-PORTER HALL
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2122
Practice Address - Country:US
Practice Address - Phone:765-494-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036352A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics