Provider Demographics
NPI:1518944263
Name:MORRIS, MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:FANNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 MEDICAL CENTER DR
Mailing Address - Street 2:PO BOX 800
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-4575
Mailing Address - Country:US
Mailing Address - Phone:507-238-8555
Mailing Address - Fax:
Practice Address - Street 1:800 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4575
Practice Address - Country:US
Practice Address - Phone:507-238-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN013R5FAOtherBLUE CROSS
MNA039OtherCHAMPUS
MNHP16183OtherHEALTHPARTNERS
MN01-13144OtherMEDICA
MNMH9040186027OtherPREFERREDONE
MN22625OtherARAZ
MN104615Medicaid
IA530709Medicaid
MN013R5FAMedicaid
MN21446OtherSIOUX VALLEY
MNA039OtherCHAMPUS
MN22625OtherARAZ
MN80013654Medicare ID - Type Unspecified
MN013R5FAMedicaid
MNP00198712Medicare ID - Type UnspecifiedRAILROAD MEDICARE