Provider Demographics
NPI:1437371192
Name:MERZ, CHRISTIAN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:LEE
Last Name:MERZ
Suffix:
Gender:M
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:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30048-0907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3685 BRASELTON HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-5920
Practice Address - Country:US
Practice Address - Phone:678-546-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20338207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD40644Medicare UPIN