Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 85586 | SC |
N | 204F00000X | Transplant Surgeon | MD00044042 | WA |
N | 208200000X | Surgeon | MD00044042 | WA |
N | 208600000X | Surgeon | MD00044042 | WA |
NPI | 1730135252 |
---|---|
Provider Name | Todd David Merchen |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-6324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
618788011A | (05) | GA |
8402638 | (05) | WA |
G58986 | (05) | SC |
H61789 | (02) | WA |