Healthcare Provider Details

I. General information

NPI: 1699969675
Provider Name (Legal Business Name): MARC MERIAN-GENAST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 08/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TRENT DR 5309 DUKE CLINIC BUILDING BOX 3000
DURHAM NC
27710-0001
US

IV. Provider business mailing address

TRENT DR 5309 DUKE CLINIC BUILDING BOX 3000
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-970-2360
  • Fax:
Mailing address:
  • Phone: 919-970-2360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number141985
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: