Provider Demographics
NPI:1194748756
Name:MORRIS, MICHAEL J (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:MR 10202
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-3683
Mailing Address - Fax:
Practice Address - Street 1:407 W 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2304
Practice Address - Country:US
Practice Address - Phone:612-798-8800
Practice Address - Fax:612-798-8816
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN27000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-09677OtherMEDICA
MN192267000Medicaid
MN930020431OtherRR MEDICARE
MNMR1081007923OtherPREFERRED ONE
MN114461OtherUCARE
MN7936683OtherARAZ
MN11929MOOtherBLUE CROSS BLUE SHIELD
MNHP21670OtherHEALTH PARTNERS
MN325101845OtherPRIMEWEST
MN114461OtherUCARE
MND79987Medicare UPIN