Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | G28294 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD19863 | OR |
NPI | 1124006598 |
---|---|
Provider Name | Dr. Thurman Allen Merritt |
First Address | Lebanon, OR 97355-9599 |
Second Address | Lebanon, OR 97355-9599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 15/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080635 | (05) | OR |
D79131 | (02) |