Provider Demographics
NPI:1891972824
Name:MORRISON, KRISTIAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIAN
Middle Name:M
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:686 S PIKE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHINNSTON
Mailing Address - State:WV
Mailing Address - Zip Code:26431-1043
Mailing Address - Country:US
Mailing Address - Phone:304-624-4655
Mailing Address - Fax:304-624-3918
Practice Address - Street 1:686 S PIKE ST
Practice Address - Street 2:
Practice Address - City:SHINNSTON
Practice Address - State:WV
Practice Address - Zip Code:26431-1043
Practice Address - Country:US
Practice Address - Phone:304-592-2100
Practice Address - Fax:304-592-2102
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV23006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810015423Medicaid
WVMO4270741Medicare PIN