Provider Demographics
NPI:1508181421
Name:MERLIN, ALVIN SIMON (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:SIMON
Last Name:MERLIN
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 HESSMER AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1525
Mailing Address - Country:US
Mailing Address - Phone:504-236-0823
Mailing Address - Fax:
Practice Address - Street 1:4525 HESSMER AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1525
Practice Address - Country:US
Practice Address - Phone:504-236-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-03
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD 9697208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology