Provider Demographics
NPI:1801953856
Name:MORPHIS PEDIATRIC GROUP
Entity type:Organization
Organization Name:MORPHIS PEDIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:MORPHIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-332-5121
Mailing Address - Street 1:708 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4765
Mailing Address - Country:US
Mailing Address - Phone:843-332-5121
Mailing Address - Fax:843-332-0993
Practice Address - Street 1:708 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4765
Practice Address - Country:US
Practice Address - Phone:843-332-5121
Practice Address - Fax:843-332-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC060Medicaid
SCPA1364Medicaid
SC049058Medicaid