Provider Demographics
NPI:1598725640
Name:MERZ, DAVID CHARLES (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:MERZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 S MIAMI BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8588
Mailing Address - Country:US
Mailing Address - Phone:954-837-2361
Mailing Address - Fax:
Practice Address - Street 1:10201 SE MAIN ST STE 29
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2937
Practice Address - Country:US
Practice Address - Phone:503-261-6028
Practice Address - Fax:503-261-6725
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29529207RI0200X
ORMD205805207RI0200X
IN01039122207RI0200X
MI4301049222207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100361910Medicaid
SC295291Medicaid
SCAA21018826Medicare PIN
SC295291Medicaid