Provider Demographics
NPI:1346777851
Name:JARRARD, MERRY
Entity Type:Individual
Prefix:
First Name:MERRY
Middle Name:
Last Name:JARRARD
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 1:4975 LACROSS RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6531
Mailing Address - Country:US
Mailing Address - Phone:843-737-9467
Mailing Address - Fax:
Practice Address - Street 1:776 DANIEL ELLIS DR STE 2A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3096
Practice Address - Country:US
Practice Address - Phone:843-795-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88722208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics