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General NPI Number Information
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NPI Number | 1972587053
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Entity Type | Individual
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Provider Name | DAVID C MERRILL MD
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 8905 W LINCOLN AVE #505
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City | WEST ALLIS
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State | WI
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Zip | 53227-2468
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Country | US
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Telephone | 414-329-5647
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Fax |
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Provider Business Mailing Address
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Address Line | 8905 W LINCOLN AVE #505
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City | WEST ALLIS
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State | WI
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Zip | 53227-2468
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Country | US
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Telephone | 414-329-5647
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 9701062
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 9701062
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License Number State | NC
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