Provider Demographics
NPI:1235963794
Name:MORRILL, ROBERT MCDANIEL
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MCDANIEL
Last Name:MORRILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SHIELDS RD APT 1
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2231
Mailing Address - Country:US
Mailing Address - Phone:202-450-0230
Mailing Address - Fax:
Practice Address - Street 1:46 SHIELDS RD APT 1
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2231
Practice Address - Country:US
Practice Address - Phone:202-450-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide