Provider Demographics
NPI:1821027822
Name:MERRITT, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MERRITT
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 1:6190 GEORGETOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6460
Mailing Address - Country:US
Mailing Address - Phone:410-552-5050
Mailing Address - Fax:410-552-0200
Practice Address - Street 1:6190 GEORGETOWN BLVD
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6460
Practice Address - Country:US
Practice Address - Phone:410-552-5050
Practice Address - Fax:410-552-0200
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD43375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD193371000OtherMEDICAL ASSISTANCE
255824OtherKAISER PERMANENTE
MD52843505OtherCAREFIRST
MD159359ZDVXOtherMEDICARE
GAP00756085OtherRAILROAD MEDICARE
226802OtherJHH
DCE402-0023OtherCAREFIRST
GAP00756085OtherRAILROAD MEDICARE