MEDICARE: CARLOS MIGUEL MERY M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	N8953	TX
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	N8953	TX
3	2086S0120X	Pediatric Surgery Physician	72113	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	701973	OTHER	TX	MEDICARE

General Provider Information

NPI Number	:	1114056215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS MIGUEL MERY M.D., M.P.H.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-322-6842
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-3079
Country	:	US
Telephone Number	:	615-322-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	11/26/2024

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