Doctor Name: | DR. MARCUS JEROME MERRIWEATHER |
NPI Number: | 1538343215 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME100398 |
Business Practice Address: | 661 E Altamonte Drive Suite 115 Altamonte Springs, FL - 327015102 |
Business Phone Number: | 4078314040 |
Business Fax Number: | 4072600281 |
Mailing Address: | 661 E Altamonte Drive, Suite 115 ALTAMONTE SPRINGS |
State: | FL |
Postal Code: | 327015102 |
Phone Number: | 4078314040 |
Fax Number: | 4072600281 |
NPI Enumeration Date: | 12/18/2007 |
NPI Last Update Date: | 12/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME100398 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |