Healthcare Provider Details
I. General information
NPI: 1821027822
Provider Name (Legal Business Name): KAREN MERRITT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2006
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2421 CHAMBERLAYNE AVE
RICHMOND VA
23222-4205
US
IV. Provider business mailing address
PO BOX 639970
CINCINNATI OH
45263-9970
US
V. Phone/Fax
- Phone: 804-329-8510
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | D43375 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101281453 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: