Healthcare Provider Details

I. General information

NPI: 1720049182
Provider Name (Legal Business Name): CHRISTOPHER A. MERRELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 TRICOM ST
N CHARLESTON SC
29406-9171
US

IV. Provider business mailing address

2880 TRICOM ST
N CHARLESTON SC
29406-9171
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-5050
  • Fax: 843-797-5050
Mailing address:
  • Phone: 843-797-5050
  • Fax: 843-797-3633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number29668
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number29668
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: