MEDICARE: DR. THOMAS CRAIG MERCHANT MD

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	174400000X	Specialist

General Provider Information

NPI Number	:	1437146255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS CRAIG MERCHANT MD

Provider Business Mailing Address
First Line	:	151 N SUNRISE AVE
Second Line	:	SUITE 1005
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-2924
Country	:	US
Telephone Number	:	916-782-1217
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 N SUNRISE AVE
Second Line	:	SUITE 1005
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-2924
Country	:	US
Telephone Number	:	916-782-1217
Fax Number	:

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	11/26/2013

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