Provider Demographics
NPI:1003911082
Name:MERRITT, WESLEY A (DC)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:A
Last Name:MERRITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JENKINS CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824
Mailing Address - Country:US
Mailing Address - Phone:603-868-1120
Mailing Address - Fax:603-868-5109
Practice Address - Street 1:13 JENKINS CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824
Practice Address - Country:US
Practice Address - Phone:603-868-1120
Practice Address - Fax:603-868-5109
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0131289A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30004830Medicaid
NH0505075Y0NH01OtherANTHEM BCBS
NHNA1709OtherHARVARD PILGRIM HEALTHCAR
U02221Medicare UPIN
NH30004830Medicaid