=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538152335
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASIF ABDUL SULTAN MERCHANT MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2005
-----------------------------------------------------
Last Update Date | 05/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 290 LITTLETON RD UNIT 3
-----------------------------------------------------
City | CHELMSFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01824-3429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-685-2460
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 290 LITTLETON RD UNIT 3
-----------------------------------------------------
City | CHELMSFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01824-3429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-685-2460
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 45064
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 231902
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 231902
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------