Provider Demographics
NPI:1700375839
Name:MERICA, JILLIAN (MD)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:MERICA
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:PHYSICIANS OFFICE BUILDING 170 MANNING DRIVE CB 7594
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PHYSICIANS OFFICE BUILDING 170 MANNING DRIVE CB 7594
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599
Practice Address - Country:US
Practice Address - Phone:919-966-6440
Practice Address - Fax:919-966-3049
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC238914390200000X
NC2021-00475207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program