Provider Demographics
NPI:1558382994
Name:MORRIS, CLIFFORD VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:VINCENT
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 1:228 JOHNSON CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836
Mailing Address - Country:US
Mailing Address - Phone:804-530-1044
Mailing Address - Fax:877-718-0972
Practice Address - Street 1:228 JOHNSON CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836
Practice Address - Country:US
Practice Address - Phone:804-530-1044
Practice Address - Fax:877-718-0972
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048464207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF79453Medicare UPIN
VAA357Medicare PIN