Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 208912 | MA |
N | 207V00000X | Obstetrician & Gynecologist | MD070229L | PA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 208912 | MA |
NPI | 1811966948 |
---|---|
Provider Name | Dr. Vikas Merchia |
First Address | Brockton, MA 02301-1168 |
Second Address | Brockton, MA 02301-1168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001861621 | (05) | PA |
2126842 | (05) | MA |
H53935 | (02) | MA |
H53935 | (02) | PA |