Provider Demographics
NPI:1700215563
Name:BROOKS, MERRIAN JACQUELINE (DO)
Entity Type:Individual
Prefix:DR
First Name:MERRIAN
Middle Name:JACQUELINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 5TH AVE
Mailing Address - Street 2:DIVISION OF ADOLESCENT AND YOUNG ADULT MEDICINE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3205
Mailing Address - Country:US
Mailing Address - Phone:412-692-6677
Mailing Address - Fax:412-692-8584
Practice Address - Street 1:3420 5TH AVE
Practice Address - Street 2:DIVISION OF ADOLESCENT AND YOUNG ADULT MEDICINE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3205
Practice Address - Country:US
Practice Address - Phone:412-692-6677
Practice Address - Fax:412-692-8584
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017178208000000X
PAOT0149852080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics