Provider Demographics
NPI:1437136173
Name:MERKEL, PETER A (MD, MPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:MERKEL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 KING OF PRUSSIA
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5220
Mailing Address - Country:US
Mailing Address - Phone:610-902-5700
Mailing Address - Fax:617-414-6031
Practice Address - Street 1:250 KING OF PRUSSIA
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-5220
Practice Address - Country:US
Practice Address - Phone:610-902-5700
Practice Address - Fax:617-638-5226
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75719207RR0500X, 207R00000X
PAMD043272L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3134431Medicaid
MAJ31010Medicare ID - Type Unspecified
MA3134431Medicaid