Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 014668 | ME |
Y | 2080P0205X | Pediatric Endocrinologist | 014668 | ME |
NPI | 1427080332 |
---|---|
Provider Name | Alan Morris |
First Address | Scarborough, ME 04074-9701 |
Second Address | Portland, ME 04102-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 31/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30200805 | (05) | ME |
322810099 | (05) | ME |
E01854 | (02) | ME |