Healthcare Provider Details

I. General information

NPI: 1760520274
Provider Name (Legal Business Name): MERIT MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HELENDALE RD SUITE 90
ROCHESTER NY
14609-3173
US

IV. Provider business mailing address

500 HELENDALE RD SUITE 90
ROCHESTER NY
14609-3173
US

V. Phone/Fax

Practice location:
  • Phone: 585-288-0530
  • Fax: 585-288-3363
Mailing address:
  • Phone: 585-288-0530
  • Fax: 585-288-3363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TAMMI L SHLOTZHAUER
Title or Position: PHYSICIAN
Credential: 5852880530
Phone: 585-288-0530