Healthcare Provider Details

I. General information

NPI: 1326158445
Provider Name (Legal Business Name): MICHAEL CHARLES MERWIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2767 OLIVE HIGHWAY DEPARTMENT OF PATHOLOGY OROVILLE HOSPITAL LOCUMS
OROVILLE CA
95966-6118
US

IV. Provider business mailing address

5700 SOUTHWYCK BLVD
TOLEDO OH
43614-1509
US

V. Phone/Fax

Practice location:
  • Phone: 530-532-8320
  • Fax:
Mailing address:
  • Phone: 707-259-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number84219
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG85015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: