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Individual

DR. HENRY JOHN MEROLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
32 SOUTH ST, SUITE 205, WALTHAM, MA 02453-3594
(781) 894-8200
(781) 894-8202
Mailing address
32 SOUTH ST, SUITE 205, WALTHAM, MA 02453-3594
(781) 894-8200
(781) 894-8202

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
59659
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1902963986
MEDICARE NPI
MA
05
3145221
MA
01
J07727
MEDICARE ID
MA
Enumeration date
01/02/2007
Last updated
03/07/2023
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