# MERITUS MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MERITUS MEDICAL CENTER INC
- **Other names:** Meritus Endocrinology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295782910
- **Legal business name:** MERITUS MEDICAL CENTER INC
- **Authorized official:** MS. VICKIE L LEACH (BUSINESS MANAGER)
- **Authorized official phone:** (301) 714-4041

## Contact information

- **Practice address:** 11110 MEDICAL CAMPUS RD, SUITE 108, HAGERSTOWN, MD 21742-6700
- **Practice address phone:** (301) 714-4041
- **Practice address fax:** (301) 714-4351
- **Mailing address:** 11110 MEDICAL CAMPUS RD, SUITE 108, HAGERSTOWN, MD 21742-6700
- **Mailing address phone:** (301) 714-4041
- **Mailing address fax:** (301) 714-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | D02101 | MD | — |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | D02116 | MD | — |
| 163WD0400X | Diabetes Educator Registered Nurse | R072839 | MD | — |
| 163WD0400X | Diabetes Educator Registered Nurse | R075263 | MD | — |
| 163WD0400X | Diabetes Educator Registered Nurse | R082255 | MD | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | D0042030 | MD | Yes |
| 363LF0000X | Family Nurse Practitioner | R175330 | MD | — |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 07/03/2013