Healthcare Provider Details

I. General information

NPI: 1558354464
Provider Name (Legal Business Name): MORRIS Z EFFRON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 AURORA ST
CAMBRIDGE MD
21613-1902
US

IV. Provider business mailing address

4 AURORA ST
CAMBRIDGE MD
21613-1902
US

V. Phone/Fax

Practice location:
  • Phone: 410-221-0333
  • Fax: 410-228-7691
Mailing address:
  • Phone: 410-221-0333
  • Fax: 410-228-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD31829
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: