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Individual

DR. SHELLEY A. MORRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
12340 BITTERSWEET COMMONS BLVD W, GRANGER, IN 46530-6959
(574) 271-8610
(574) 271-8620
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003725A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200994220
IN
01
236040021
MEDICARE PTAN
IN
Enumeration date
09/03/2007
Last updated
03/31/2021
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