Basic Information
| Provider Information | |||||||||
| NPI: | 1194748756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2925 CHICAGO AVE | ||||||||
| Address2: | MR 10202 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554071321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122623683 | ||||||||
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| Practice Location | |||||||||
| Address1: | 407 W 66TH ST | ||||||||
| Address2: | |||||||||
| City: | RICHFIELD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554232304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6127988800 | ||||||||
| FaxNumber: | 6127988816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 27000 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01-09677 | 01 | MN | MEDICA | OTHER | 192267000 | 05 | MN | MEDICAID | 930020431 | 01 | MN | RR MEDICARE | OTHER | MR1081007923 | 01 | MN | PREFERRED ONE | OTHER | 114461 | 01 | MN | UCARE | OTHER | 7936683 | 01 | MN | ARAZ | OTHER | 11929MO | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | HP21670 | 01 | MN | HEALTH PARTNERS | OTHER | 325101845 | 01 | MN | PRIMEWEST | OTHER |