Provider Demographics
NPI:1467696807
Name:MORRIS, THOMAS WARDEN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS WARDEN
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 1:514 DANIELS ST
Mailing Address - Street 2:SUITE 187
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1317
Mailing Address - Country:US
Mailing Address - Phone:919-200-8650
Mailing Address - Fax:
Practice Address - Street 1:514 DANIELS ST
Practice Address - Street 2:SUITE 187
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1317
Practice Address - Country:US
Practice Address - Phone:919-200-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA745812083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine