Healthcare Provider Details

I. General information

NPI: 1386059749
Provider Name (Legal Business Name): HALLIE FARYN MORRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 11/28/2022
Certification Date: 11/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW STE 3600W
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW STE 3600W
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 904-504-1148
  • Fax: 314-454-4102
Mailing address:
  • Phone: 904-504-1148
  • Fax: 314-454-4102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2014018094
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD048055
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: