Provider Demographics
NPI:1407919863
Name:MORRIS, VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
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 1:385 CHURCH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2003
Mailing Address - Country:US
Mailing Address - Phone:203-453-0361
Mailing Address - Fax:203-453-8510
Practice Address - Street 1:385 CHURCH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2003
Practice Address - Country:US
Practice Address - Phone:203-453-0361
Practice Address - Fax:203-453-8510
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032859207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF64827Medicare UPIN
CT110008676Medicare ID - Type Unspecified
CT110009417Medicare ID - Type Unspecified