MEDICARE: MR. SAMUEL DAVID 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	207Q00000X	Family Medicine Physician	12716	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9930421	OTHER	WV	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10269	OTHER	WV	RAILROAD GROUP
3	080020708	OTHER	WV	RAILROAD INDIVIDUAL ID#

General Provider Information

NPI Number	:	1427092956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAMUEL DAVID MORRIS M.D.

Provider Business Mailing Address
First Line	:	101 MARCLEY DR
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-2977
Country	:	US
Telephone Number	:	304-263-8911
Fax Number	:	304-263-9450

Provider Business Practice Location Address
First Line	:	101 MARCLEY DR
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-2977
Country	:	US
Telephone Number	:	304-263-8911
Fax Number	:	304-263-9450

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/11/2021

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Directions to “ MR. SAMUEL DAVID MORRIS M.D.” Practice Location

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