Provider Demographics
NPI:1265475636
Name:MERRELL, BETSY SALSBURY (MD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:SALSBURY
Last Name:MERRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N JUSTICE ST # 16
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3410
Mailing Address - Country:US
Mailing Address - Phone:828-694-8385
Mailing Address - Fax:828-694-8385
Practice Address - Street 1:611 5TH AVE W STE B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739
Practice Address - Country:US
Practice Address - Phone:828-698-3301
Practice Address - Fax:828-698-7133
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903994Medicaid
NC2053105COtherMEDICARE PTAN
NC2053105COtherMEDICARE PTAN