Provider Demographics
NPI:1124667191
Name:MORRIS S MINTON MD FAAD PA
Entity type:Organization
Organization Name:MORRIS S MINTON MD FAAD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MINTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-291-3415
Mailing Address - Street 1:87 ELM ST STE 104A
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1963
Mailing Address - Country:US
Mailing Address - Phone:207-230-8400
Mailing Address - Fax:207-430-8611
Practice Address - Street 1:87 ELM ST STE 104A
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1963
Practice Address - Country:US
Practice Address - Phone:207-230-8400
Practice Address - Fax:207-430-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty