MEDICARE: NASREEN 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	208000000X	Pediatrics Physician	4301052988	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C7096	OTHER	MI	MCARE
2	P76422	OTHER	MI	BLUE CROSS
3	4573545	OTHER	MI	AETNA
4	139951	OTHER	MI	CARE CHOICES
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	633369	OTHER	MI	BLUE CROSS
8	3506333691	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1912949645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NASREEN MERCHANT MD

Provider Business Mailing Address
First Line	:	23133 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON
State	:	MI
Zip	:	48336-3268
Country	:	US
Telephone Number	:	248-477-0100
Fax Number	:	248-477-6153

Provider Business Practice Location Address
First Line	:	23133 ORCHARD LAKE RD
Second Line	:	SUITE 100
City	:	FARMINGTON
State	:	MI
Zip	:	48336-3268
Country	:	US
Telephone Number	:	248-477-0100
Fax Number	:	248-477-6153

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/08/2007

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Directions to “ NASREEN MERCHANT MD” Practice Location

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