Provider Demographics
NPI:1346227352
Name:MERCHANT, NOOR MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:NOOR
Middle Name:MOHAMMED
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:13060 US HIGHWAY 1
Practice Address - Street 2:SUITE A
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3771
Practice Address - Country:US
Practice Address - Phone:772-589-0879
Practice Address - Fax:844-812-2806
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47346207R00000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013810700Medicaid
FL013810700Medicaid
FL31186YMedicare PIN