Provider Demographics
NPI:1477668853
Name:MORRIS, GREGORY BRETT (DPM)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:BRETT
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 608
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2449
Mailing Address - Country:US
Mailing Address - Phone:808-536-2261
Mailing Address - Fax:808-538-3957
Practice Address - Street 1:1329 LUSITANA ST
Practice Address - Street 2:SUITE 802
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2429
Practice Address - Country:US
Practice Address - Phone:808-532-3338
Practice Address - Fax:808-525-6868
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIPO150213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50000002Medicaid
HI50000002Medicaid
HIU87235Medicare UPIN