Organization
MERRY MEDICAL TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GORDON MERRY MD (PRESIDENT)
(775) 782-1603
Entity
Organization
Contact information
Practice address
1649 LUCERNE ST, STE A & B, MINDEN, NV 89423-4363
(775) 782-1603
(775) 782-3427
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NV
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506316
—
NV
Enumeration date
02/23/2006
Last updated
07/21/2022
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