Provider Demographics
NPI:1194779538
Name:MORRIS, SHANNON R (MD, PHD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:R
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PHYSICIANS OFFICE BUILDING 3RD FLOOR CB 7305
Mailing Address - Street 2:170 MANNING DRIVE
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-483-7282
Mailing Address - Fax:
Practice Address - Street 1:PHYSICIANS OFFICE BUILDING 3RD FLOOR CB 7305
Practice Address - Street 2:170 MANNING DRIVE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-483-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500605208M00000X
NC2005-00605207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891250AMedicaid
NC891250AMedicaid
NC891250AMedicaid
BM9685453OtherDEA