Provider Demographics
NPI:1649276379
Name:DIOKNO-MORRIS, MARIA ANGELINE S (MD)
Entity type:Individual
Prefix:
First Name:MARIA ANGELINE
Middle Name:S
Last Name:DIOKNO-MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELINE
Other - Middle Name:S
Other - Last Name:DIOKNO-MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6983 HILLSDALE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2054
Mailing Address - Country:US
Mailing Address - Phone:317-849-8350
Mailing Address - Fax:317-576-6311
Practice Address - Street 1:1400 N RITTER AVE STE 220
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3046
Practice Address - Country:US
Practice Address - Phone:317-715-5600
Practice Address - Fax:317-715-5618
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055004A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200342580Medicaid
IN000000201083OtherANTHEM BXBS
IN200342580Medicaid
IN000000201083OtherANTHEM BXBS