Provider Demographics
NPI:1497743033
Name:MERCHANT, WILLIAM T (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-639-3230
Mailing Address - Fax:717-274-1659
Practice Address - Street 1:720 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7481
Practice Address - Country:US
Practice Address - Phone:717-639-3230
Practice Address - Fax:717-274-1659
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45281207L00000X
PAOS005477L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48132268Medicaid
PA0009825890001Medicaid
C33640Medicare UPIN
COCO306916Medicare PIN
412510HEVMedicare ID - Type Unspecified