Provider Demographics
NPI:1811015704
Name:MORRIS, ANGELA M (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6614 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-9303
Mailing Address - Country:US
Mailing Address - Phone:336-945-2080
Mailing Address - Fax:336-945-2039
Practice Address - Street 1:6614 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-9303
Practice Address - Country:US
Practice Address - Phone:336-945-2080
Practice Address - Fax:336-945-2039
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35089606207Q00000X
NC2010-00107207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2010-00107OtherNC MEDICAL LICENSE
SC57-0359174OtherTAX ID
SC57-0359174OtherTAX ID