Healthcare Provider Details

I. General information

NPI: 1164730008
Provider Name (Legal Business Name): COURTNEY MERCHANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COURTNEY LEE M.D.

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901-2597
US

IV. Provider business mailing address

301 S 8TH ST STE 1D
PHILADELPHIA PA
19106-4015
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-2966
  • Fax:
Mailing address:
  • Phone: 158-293-1912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA111959
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD468963
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA111959
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: