Healthcare Provider Details

I. General information

NPI: 1639557903
Provider Name (Legal Business Name): JEAN PAUL GOTTRET MERKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KENYON AVE
WAKEFIELD RI
02879-4216
US

IV. Provider business mailing address

24 LION ST
EAST GREENWICH RI
02818-3729
US

V. Phone/Fax

Practice location:
  • Phone: 401-782-8000
  • Fax:
Mailing address:
  • Phone: 215-720-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD16882
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: