Provider Demographics
NPI:1225599921
Name:AZAB, MERIT GERGES
Entity Type:Individual
Prefix:
First Name:MERIT
Middle Name:GERGES
Last Name:AZAB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 FORGE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3028
Mailing Address - Country:US
Mailing Address - Phone:615-810-4391
Mailing Address - Fax:
Practice Address - Street 1:2113 FORGE RIDGE CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3028
Practice Address - Country:US
Practice Address - Phone:615-810-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3825363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant