Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 35077067 | OH |
NPI | 1003876152 |
---|---|
Provider Name | Matthew Joseph Morrison |
First Address | Columbus, OH 43220-1809 |
Second Address | Columbus, OH 43220-1809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000231317 | ANTHEM (01) | OH |
1203481 | UNITED HEALTHCARE (01) | OH |