Healthcare Provider Details

I. General information

NPI: 1821829805
Provider Name (Legal Business Name): MATTHEW COLLIN MERKEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 2ND AVE S
BIRMINGHAM AL
35294-0004
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3411
  • Fax: 205-996-0432
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.2682
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: