Healthcare Provider Details

I. General information

NPI: 1730303777
Provider Name (Legal Business Name): SARAH A MERRITT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MITCHELLVILLE RD SUITE B322
BOWIE MD
20716-3104
US

IV. Provider business mailing address

4000 MITCHELLVILLE RD SUITE B322
BOWIE MD
20716-3104
US

V. Phone/Fax

Practice location:
  • Phone: 301-860-0305
  • Fax: 301-860-0307
Mailing address:
  • Phone: 301-860-0305
  • Fax: 301-860-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2005-01617
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number52391
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD0065944
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: