MEDICARE: NADEEM MERCHANT DMD

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	122300000X	Dentist	DE9766	WA

General Provider Information

NPI Number	:	1114142841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADEEM MERCHANT DMD

Provider Business Mailing Address
First Line	:	3003 ISLAND CREST WAY
Second Line	:	SUITE #2
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2998
Country	:	US
Telephone Number	:	206-232-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 ISLAND CREST WAY
Second Line	:	SUITE #2
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2998
Country	:	US
Telephone Number	:	206-232-6200
Fax Number	:

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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