Provider Demographics
NPI:1316969579
Name:MORRIS, AMANDA L (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13914 SOUTHEASTERN PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7125
Mailing Address - Country:US
Mailing Address - Phone:317-415-9900
Mailing Address - Fax:317-415-9910
Practice Address - Street 1:13914 SOUTHEASTERN PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7127
Practice Address - Country:US
Practice Address - Phone:317-415-9900
Practice Address - Fax:317-415-9910
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01056469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200527810Medicaid
IN200527810Medicaid
IN220170CCMedicare PIN