Provider Demographics
NPI:1871951145
Name:DAVIS, MORGAN LIBORIO
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LIBORIO
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7346
Mailing Address - Country:US
Mailing Address - Phone:910-254-9995
Mailing Address - Fax:910-254-9996
Practice Address - Street 1:1099 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7346
Practice Address - Country:US
Practice Address - Phone:910-254-9995
Practice Address - Fax:910-254-9996
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-06251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant