Provider Demographics
NPI:1053758607
Name:MORRIS, ELAINE WINIFRED (MD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:WINIFRED
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 W CALIMYRNA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1871
Mailing Address - Country:US
Mailing Address - Phone:559-451-0721
Mailing Address - Fax:
Practice Address - Street 1:1752 W CALIMYRNA AVE APT B
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1871
Practice Address - Country:US
Practice Address - Phone:559-451-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36105207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology