Basic Information
Provider Information
NPI: 1467983254
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: DWAYNE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12420 MILESTONE CENTER DR STE 200
Address2:  
City: GERMANTOWN
State: MD
PostalCode: 208767111
CountryCode: US
TelephoneNumber: 2406862300
FaxNumber:  
Practice Location
Address1: 600 GRESHAM DR
Address2: ROOM 304 RALEIGH BUILDING
City: NORFOLK
State: VA
PostalCode: 235071904
CountryCode: US
TelephoneNumber: 7573883397
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2017
LastUpdateDate: 06/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RC0200X.VAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207P00000X010126878VAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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