Provider Demographics
NPI:1740379916
Name:MORRISON, EDWARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:MORRISON
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 1:1327 ASHLEY RIVER ROAD, BUILDING B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407
Mailing Address - Country:US
Mailing Address - Phone:843-577-4551
Mailing Address - Fax:843-577-2227
Practice Address - Street 1:851 LEONARD FULGHUM DR STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3793
Practice Address - Country:US
Practice Address - Phone:843-936-5951
Practice Address - Fax:843-936-5952
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225000000X
SC122902086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA1729Medicaid
SC020019900OtherRAILROAD MEDICARE
SCS02120OtherCIGNA
SC122904Medicaid
SC610303400OtherU S DEPARTMENT OF LABOR
SC37254OtherMEDCOST
SC0489056OtherAETNA
SC570661850OtherFEDERAL TAX ID
SC0489056OtherAETNA
SCD055781841Medicare ID - Type Unspecified
SC122904Medicaid