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General NPI Number Information
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NPI Number | 1649701731
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Entity Type | Individual
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Provider Name | MRUGA NANAVATI MORRIS MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 919-784-3298
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100237
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City | GAINESVILLE
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State | FL
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Zip | 32610-3001
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Country | US
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Telephone | 352-265-9522
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Fax | 352-265-3575
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2022-01261
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 2022-01261
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | A169463
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License Number State | CA
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