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Individual

JOHN R MERTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2145 MOUNT PLEASANT BLVD SE, ROANOKE, VA 24014-3632
(540) 427-9200
Mailing address
2145 MOUNT PLEASANT BLVD SE, ROANOKE, VA 24014-3632

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-044038
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080053877
RR MEDICARE PIN
VA
05
1689656209
VA
Enumeration date
11/18/2005
Last updated
03/10/2011
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