Provider Demographics
NPI:1487625828
Name:NASS, MERYL (MD)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:NASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WAYMAN LN
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1625
Mailing Address - Country:US
Mailing Address - Phone:207-288-8052
Mailing Address - Fax:207-288-8612
Practice Address - Street 1:17 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1714
Practice Address - Country:US
Practice Address - Phone:207-288-5024
Practice Address - Fax:207-288-4840
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014575208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME175330099Medicaid
MEE45671Medicare UPIN
ME175330099Medicaid