Provider Demographics
NPI:1083867147
Name:MERRIAM, MARGARET (MARGARET MERRIAM DO)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MERRIAM
Suffix:
Gender:F
Credentials:MARGARET MERRIAM DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3638
Mailing Address - Country:US
Mailing Address - Phone:432-523-6624
Mailing Address - Fax:432-524-1129
Practice Address - Street 1:700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3638
Practice Address - Country:US
Practice Address - Phone:432-523-6624
Practice Address - Fax:432-524-1129
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-02
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09593600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery