MEDICARE: DR. DONALD JAY MORRIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	57198	MA
2	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	57198	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	57198	OTHER	MA	MASS. STATE LICENSE NUMBE

General Provider Information

NPI Number	:	1053300145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD JAY MORRIS M.D.

Provider Business Mailing Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 210
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-383-6250
Fax Number	:	617-383-6255

Provider Business Practice Location Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 210
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-383-6250
Fax Number	:	617-383-6255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	09/29/2011

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