1619415973 NPI number — MATTHEW P MORRIS DNP

Table of content: MATTHEW P MORRIS DNP (NPI 1619415973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619415973 NPI number — MATTHEW P MORRIS DNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS
Provider First Name:
MATTHEW
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619415973
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
885 MACBETH DR
Provider Second Line Business Mailing Address:
HEARTLAND CARE PARTNERS
Provider Business Mailing Address City Name:
MONROEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15146-3332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-427-1902
Provider Business Mailing Address Fax Number:
419-531-2664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 N SUMMIT ST FL 7
Provider Second Line Business Practice Location Address:
HCR MANORCARE MEDICAL SERVICES / HEARTLAND CARE PARTNER
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43604-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-427-1902
Provider Business Practice Location Address Fax Number:
419-531-2664
Provider Enumeration Date:
02/07/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  SP016959 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)