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General NPI Number Information
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NPI Number | 1093930604
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Entity Type | Individual
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Provider Name | DONNA ZELLA MERRILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 4615 EASTMAN AVENUE
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City | MIDLAND
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State | MI
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Zip | 48642-6825
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Country | US
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Telephone | 989-631-7110
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Fax | 989-892-7455
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Provider Business Mailing Address
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Address Line | 1913 TRAILWOOD CIR E
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City | MIDLAND
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State | MI
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Zip | 48642-6825
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Country | US
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Telephone | 989-832-0857
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Fax | 989-667-9661
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601003003
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License Number State | MI
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