Individual
GREGORY W MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
473 COLONY DR # 82, FAIRHOPE, AL 36532-7173
(601) 310-4425
Mailing address
473 COLONY DR # 82, FAIRHOPE, AL 36532-7173
(601) 310-4425
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
09640
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115630
—
MS
05
—
009936058
—
AL
01
—
1559011
AMERICAN ADMIN GROUP
MS
05
—
1974625
—
LA
01
—
370009685
RAILROAD MEDICARE
MS
Enumeration date
08/20/2006
Last updated
03/30/2021
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