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General NPI Number Information
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NPI Number | 1629463898
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Entity Type | Individual
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Provider Name | MARCUS SAMUEL MERMELSTEIN PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE BLDG 9A FL 3, SURGICAL ICU
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City | BETHESDA
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State | MD
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Zip | 20889-5367
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Country | US
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Telephone | 301-400-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 8901 WISCONSIN AVE BLDG 9A FL 3, SURGICAL ICU
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-400-0018
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Fax |
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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 | C0007408
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License Number State | MD
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