MEDICARE: DR. CHRISTIAN LEE MERZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	20338	GA

General Provider Information

NPI Number	:	1437371192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN LEE MERZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 907
Second Line	:
City	:	LILBURN
State	:	GA
Zip	:	30048-0907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3685 BRASELTON HWY
Second Line	:	SUITE 106
City	:	DACULA
State	:	GA
Zip	:	30019-5920
Country	:	US
Telephone Number	:	678-546-4570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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