Healthcare Provider Details

I. General information

NPI: 1346313475
Provider Name (Legal Business Name): PETER JOSEPH MORRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 CAPITAL BLVD
RALEIGH NC
27603-1118
US

IV. Provider business mailing address

1390 CAPITAL BLVD
RALEIGH NC
27603-1118
US

V. Phone/Fax

Practice location:
  • Phone: 919-414-5050
  • Fax: 919-836-1352
Mailing address:
  • Phone: 919-256-2165
  • Fax: 919-836-1352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25065
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number25605
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: