Provider Demographics
NPI:1326350026
Name:MERRIFIELD, DAVID KEITH (CSA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KEITH
Last Name:MERRIFIELD
Suffix:
Gender:M
Credentials:CSA
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 10825
Mailing Address - Street 2:CONTANT 11-3KB, STT, VI 00802
Mailing Address - City:CHARLOTTE AMALIE
Mailing Address - State:VI
Mailing Address - Zip Code:00801-3825
Mailing Address - Country:US
Mailing Address - Phone:340-998-3084
Mailing Address - Fax:
Practice Address - Street 1:CONTANT 11-3KB
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-3003
Practice Address - Fax:340-776-3029
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical