Healthcare Provider Details

I. General information

NPI: 1265882377
Provider Name (Legal Business Name): MEAGHAN MORRIS MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGHAN O'MALLEY

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST PATHOLOGY DEPARTMENT
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 571-212-5821
  • Fax:
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberD88512
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberD88512
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: