MEDICARE: SHANNATH MERBS M.D.

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	207W00000X	Ophthalmology Physician	0101285381	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750330502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNATH MERBS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 749112
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9112
Country	:	US
Telephone Number	:	434-295-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2955 IVY RD
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22908-0005
Country	:	US
Telephone Number	:	434-924-5485
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	06/09/2025

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