Provider Demographics
NPI:1801970207
Name:WASHINGTON, MORRIS J III (MD)
Entity type:Individual
Prefix:
First Name:MORRIS
Middle Name:J
Last Name:WASHINGTON
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 DOUG WHITE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4180
Mailing Address - Country:US
Mailing Address - Phone:843-353-5360
Mailing Address - Fax:843-353-5363
Practice Address - Street 1:920 DOUG WHITE DR STE 150
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4180
Practice Address - Country:US
Practice Address - Phone:843-353-5360
Practice Address - Fax:843-353-5363
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33274208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0014958Medicaid
SC7844Medicare PIN
NJA61512Medicare UPIN
SCGP4505Medicaid
NJ074730Medicare PIN