Provider Demographics
NPI:1235831512
Name:MERIT HEALTH
Entity Type:Organization
Organization Name:MERIT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IGWEBUIKE
Authorized Official - Middle Name:MOSES
Authorized Official - Last Name:UDEZE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:404-693-5565
Mailing Address - Street 1:3721 NEW MACLAND RD STE 200-193
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2000
Mailing Address - Country:US
Mailing Address - Phone:404-693-5565
Mailing Address - Fax:920-212-2048
Practice Address - Street 1:4910 BROWN LEAF DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-8918
Practice Address - Country:US
Practice Address - Phone:404-693-5565
Practice Address - Fax:920-212-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty