Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0420012849 | VT |
N | 111NI0900X | Internist | 0420012849 | VT |
Y | 207RH0000X | Hematologist | 29029 | WV |
N | 207RH0000X | Hematologist | D0097056 | MD |
NPI | 1144529769 |
---|---|
Provider Name | Dr. Samuel Merrill |
First Address | Morgantown, WV 26506-9162 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2011 |
Last Update Date | 13/11/2019 |