Physician Compare National (NPI:1497070254)

HEALTHCARE PROVIDER: HALEY MARIE MERRILL M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1497070254
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739494865
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190610001126
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MERRILL
	Individual professional last name
Provider First Name	HALEY
	Individual professional first name
Provider Middle Name	MARIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TRI-COUNTY SURGICAL SPECIALISTS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1658540505
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	25
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	9300 MEDICAL PLAZA DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	CHARLESTON
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	294069334
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8437641731
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420079
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRIDENT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y