Provider Demographics
NPI:1306120357
Name:H CURTISS MERRICK MD PA
Entity type:Organization
Organization Name:H CURTISS MERRICK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:CURTISS
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:252-222-5790
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-0914
Mailing Address - Country:US
Mailing Address - Phone:252-222-5790
Mailing Address - Fax:252-222-5787
Practice Address - Street 1:3715 GUARDIAN AVE
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4323
Practice Address - Country:US
Practice Address - Phone:252-222-5790
Practice Address - Fax:252-222-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918817Medicaid
NCA664Medicare PIN