Healthcare Provider Details

I. General information

NPI: 1023194016
Provider Name (Legal Business Name): PATRICK J MORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 DELAWARE STREET SE, CLINIC 3A UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

420 DELAWARE ST SE, MMC 381 UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-884-0999
  • Fax:
Mailing address:
  • Phone: 612-884-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number37464
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number38868
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: