Provider Demographics
NPI:1417546490
Name:MERUS GASTROENTEROLOGY & GUT HEALTH LLC
Entity Type:Organization
Organization Name:MERUS GASTROENTEROLOGY & GUT HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-608-2973
Mailing Address - Street 1:3651 PEACHTREE PKWY STE E359
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3890 JOHNS CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1286
Practice Address - Country:US
Practice Address - Phone:717-608-2973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty