Provider Demographics
NPI:1346436391
Name:MORRISON, SERENA A (MD)
Entity Type:Individual
Prefix:
First Name:SERENA
Middle Name:A
Last Name:MORRISON
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 1:158 NORTHPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6060
Mailing Address - Country:US
Mailing Address - Phone:207-338-2571
Mailing Address - Fax:207-338-3810
Practice Address - Street 1:158 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6060
Practice Address - Country:US
Practice Address - Phone:207-338-2571
Practice Address - Fax:207-338-3810
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432472207W00000X
MEMD20246207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty