Provider Demographics
NPI:1154697878
Name:MERLIN, GABRIEL (MD AS OF JUNE 2012)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MERLIN
Suffix:
Gender:M
Credentials:MD AS OF JUNE 2012
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CONANT ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2796
Mailing Address - Country:US
Mailing Address - Phone:978-927-3040
Mailing Address - Fax:
Practice Address - Street 1:152 CONANT ST STE 301
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1659
Practice Address - Country:US
Practice Address - Phone:978-927-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA283063207XS0106X
NHLT4191207X00000X
IL036-144953207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program