Provider Demographics
NPI:1790914844
Name:MEESE, MERRICK M (MD)
Entity Type:Individual
Prefix:DR
First Name:MERRICK
Middle Name:M
Last Name:MEESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MAC
Other - Middle Name:M
Other - Last Name:MEESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:619 19TH ST S
Mailing Address - Street 2:JT 845
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-6810
Mailing Address - Country:US
Mailing Address - Phone:205-934-4696
Mailing Address - Fax:
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:JT 845
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-6810
Practice Address - Country:US
Practice Address - Phone:205-934-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.33591207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology