Healthcare Provider Details

I. General information

NPI: 1992752984
Provider Name (Legal Business Name): MERRILL I. MOREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NO. 16TH ST
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

PO BOX 412
NEW CASTLE IN
47362-0412
US

V. Phone/Fax

Practice location:
  • Phone: 765-599-3494
  • Fax: 765-521-1331
Mailing address:
  • Phone: 765-599-3494
  • Fax: 765-521-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01038473A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: