Provider Demographics
NPI:1760419931
Name:MORRIS, WILLIAM HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:MORRIS
Suffix:JR
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 1:404 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483
Mailing Address - Country:US
Mailing Address - Phone:843-871-8366
Mailing Address - Fax:843-873-0100
Practice Address - Street 1:404 N PINE ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-871-8366
Practice Address - Fax:843-873-0100
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6747208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC067475Medicaid
D991740281Medicare ID - Type Unspecified
SC067475Medicaid