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General NPI Number Information
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NPI Number | 1821276163
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Entity Type | Organization
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Legal Business Name | MERITAS MEDICAL, INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 2000 TAMARACK RD
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City | NEWARK
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State | OH
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Zip | 43055-1183
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Country | US
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Telephone | 614-297-1158
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Fax | 614-299-3409
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Provider Business Mailing Address
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Address Line | 100 W THIRD AVE STE 150
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City | COLUMBUS
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State | OH
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Zip | 43201
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Country | US
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Telephone | 614-297-1158
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Fax | 614-299-3406
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Authorized Official
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Title or Position | OWNER
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Name | ALEX JUAN
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Credential | M.D.
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Telephone | 614-297-1158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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