MEDICARE: SIDNEY EMMETT MORRISON III MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208C00000X	Colon & Rectal Surgery Physician	13351	SC
2	208600000X	Surgery Physician	13351	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	280001192	OTHER	SC	RAILROAD MEDICARE
3	P00868707	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942200431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDNEY EMMETT MORRISON III MD

Provider Business Mailing Address
First Line	:	114 GATEWAY CORPORATE BLVD STE 120
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-9785
Country	:	US
Telephone Number	:	803-865-4594
Fax Number	:	803-865-4595

Provider Business Practice Location Address
First Line	:	114 GATEWAY CORPORATE BLVD STE 120
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-9785
Country	:	US
Telephone Number	:	803-865-4594
Fax Number	:	803-865-4595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	09/08/2023

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