Provider Demographics
NPI:1700904083
Name:MORRIS, NALINI OBILISUNDA (DO)
Entity type:Individual
Prefix:DR
First Name:NALINI
Middle Name:OBILISUNDA
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MARKET AVE N
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1017
Mailing Address - Country:US
Mailing Address - Phone:330-493-4553
Mailing Address - Fax:330-493-3762
Practice Address - Street 1:624 MARKET AVE N
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1017
Practice Address - Country:US
Practice Address - Phone:330-493-4553
Practice Address - Fax:330-493-3761
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-0051382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151179Medicaid
OH151179Medicaid
OH151179Medicaid
OHMO4283282Medicare PIN
OH0151179Medicaid