Provider Demographics
NPI:1871732321
Name:MORRIS, MEGAN MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MICHELLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MICHELLE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:720 WASHINGTON AVE SE STE 300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2904
Mailing Address - Country:US
Mailing Address - Phone:612-273-3000
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-273-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2127207L00000X
MN68901207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201032402Medicaid
TXP00915784OtherRAILROAD
TX201032403Medicaid
TX8BZ259OtherBCBS
TX201032404Medicaid
TX8EL141OtherBCBS TX
TX201032401Medicaid
TX8BZ259OtherBCBS
TXTXB162722Medicare PIN
TX201032404Medicaid