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NPI Code Detail

MEDICARE: SONYA J. MERRIMAN M.D.

MEDICARE: SONYA J. MERRIMAN 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
1208200000XPlastic Surgery Physician029038GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1029038OTHERGAMEDICAL LICENSE

General Provider Information

NPI Number : 1811005655
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONYA J. MERRIMAN M.D.
Provider Business Mailing Address
First Line : 230 NORTHSIDE DR
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1858
Country : US
Telephone Number : 229-242-3002
Fax Number :
Provider Business Practice Location Address
First Line : 230 NORTHSIDE DR
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1858
Country : US
Telephone Number : 229-242-3002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/08/2007

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