MEDICARE: DR. ALTAF 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	2084P0800X	Psychiatry Physician	D0023416	MD

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	:	1912027707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALTAF MERCHANT MD

Provider Business Mailing Address
First Line	:	1804 BY WOODS LN
Second Line	:
City	:	STEVENSON
State	:	MD
Zip	:	21153-0630
Country	:	US
Telephone Number	:	410-484-9955
Fax Number	:	410-602-2178

Provider Business Practice Location Address
First Line	:	5500 KNOLL NORTH DR STE 290
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2209
Country	:	US
Telephone Number	:	301-317-6575
Fax Number	:	301-317-9736

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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