Organization
MERITUS MEDICAL CENTER INC
Active
Parent organization
MERITUS MEDICAL CENTER INC
Other names
Meritus Endocrinology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERITUS MEDICAL CENTER INC
Authorized official
MS. VICKIE L LEACH (BUSINESS MANAGER)
(301) 714-4041
Entity
Organization
Contact information
Practice address
11110 MEDICAL CAMPUS RD, SUITE 108, HAGERSTOWN, MD 21742-6700
(301) 714-4041
(301) 714-4351
Mailing address
11110 MEDICAL CAMPUS RD, SUITE 108, HAGERSTOWN, MD 21742-6700
(301) 714-4041
(301) 714-4351
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
D0042030
MD
363LF0000X
Family Nurse Practitioner
R175330
MD
Other
Enumeration date
05/28/2006
Last updated
07/03/2013
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