Individual
MARK ERIC MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2840 S MERIDIAN RD, MERIDIAN, ID 83642-7960
(208) 593-6393
(208) 593-6402
Mailing address
2840 S MERIDIAN RD, MERIDIAN, ID 83642-7960
(208) 593-6393
(208) 593-6402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
GPA-054
ID
363A00000X
Physician Assistant
Primary
PA-1054
ID
Other
Enumeration date
11/23/2012
Last updated
09/09/2025
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