Provider Demographics
NPI:1235308263
Name:MERRICK, MICHAEL OSEI (MPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:OSEI
Last Name:MERRICK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1597
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013-1597
Mailing Address - Country:US
Mailing Address - Phone:202-277-7887
Mailing Address - Fax:
Practice Address - Street 1:14000 JERICHO PARK RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-3319
Practice Address - Country:US
Practice Address - Phone:202-277-7887
Practice Address - Fax:240-419-3090
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-24
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM620603648470225100000X
DCPT870782225100000X
MD22283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist