Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD12631 | RI |
Y | 2080P0204X | Pediatric Emergency Doctor | MD12631 | RI |
NPI | 1174660211 |
---|---|
Provider Name | Dr. Christopher Howell Merritt |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0070607981 | RI MEDICARE (01) | RI |
2163276 | (05) | MA |
CM73322 | (05) | RI |