Provider Demographics
NPI:1487643862
Name:MORRIS, DAVID WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2142
Mailing Address - Country:US
Mailing Address - Phone:412-847-2615
Mailing Address - Fax:412-847-2623
Practice Address - Street 1:1130 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2142
Practice Address - Country:US
Practice Address - Phone:412-847-2615
Practice Address - Fax:412-847-2623
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044520L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014027720005Medicaid
PAF15133Medicare UPIN
PA707768Medicare PIN