Provider Demographics
NPI:1215461801
Name:MORGAN, ANDRE NICHOLAS (MBBS)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:NICHOLAS
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVENUE NW, 5C-26
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060
Mailing Address - Country:US
Mailing Address - Phone:202-865-1924
Mailing Address - Fax:202-865-7199
Practice Address - Street 1:2041 GEORGIA AVENUE NW, 5C-26
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060
Practice Address - Country:US
Practice Address - Phone:202-865-1924
Practice Address - Fax:202-865-7199
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61505715207R00000X
LA323820207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine