Provider Demographics
NPI:1710244926
Name:MERRIMAN, SAMAR BENHUSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMAR
Middle Name:BENHUSEN
Last Name:MERRIMAN
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 1:14701 LEE HWY STE 304
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2135
Mailing Address - Country:US
Mailing Address - Phone:703-830-4388
Mailing Address - Fax:
Practice Address - Street 1:14701 LEE HWY STE 304
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2135
Practice Address - Country:US
Practice Address - Phone:703-830-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260839207V00000X
MDD0082061207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology