Provider Demographics
NPI:1922480821
Name:MORRIS, GILLIAN AMBER (MD)
Entity Type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:AMBER
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2231
Mailing Address - Country:US
Mailing Address - Phone:401-863-3953
Mailing Address - Fax:401-863-7953
Practice Address - Street 1:450 BROOK ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02912-5615
Practice Address - Country:US
Practice Address - Phone:401-863-3953
Practice Address - Fax:401-863-7953
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA264650207Q00000X
RIMD16324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine