| Organization Name: | MERRITT MEDICAL & PROFESSIONAL |
| NPI Number: | 1316268154 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS SCOTT MERRITT (PHYSICIAN/OWNER) |
| Mailing Address: | 1511 Crystal Valley Ct Se Caledonia |
| State: | MI US |
| Postal Code: | 493168118 |
| Phone Number: | 6166563199 |
| Fax Number: | 6166563199 |
| NPI Enumeration Date: | 06/16/2010 |
| NPI Last Update Date: | 06/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 4301069990 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |