Individual
MINDY LEE NACE MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
306 MEDICAL PARK CT, MOREHEAD CITY, NC 28557-4346
(252) 247-2101
(252) 247-4675
Mailing address
306 MEDICAL PARK CT, MOREHEAD CITY, NC 28557-4346
(252) 247-2101
(252) 247-4675
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
141282
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1714P
BLUE CROSS BLUE SHIELD
NC
05
—
5920642
—
NC
01
—
P01312592
RR MEDICARE
NC
Enumeration date
07/11/2007
Last updated
05/29/2024
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