Provider Demographics
NPI:1851410351
Name:DR. MERLYN K. D. VEMURY MD PC
Entity Type:Organization
Organization Name:DR. MERLYN K. D. VEMURY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERLYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:VEMURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-593-7792
Mailing Address - Street 1:9801 GEORGIA AVE
Mailing Address - Street 2:SUITE 227
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5276
Mailing Address - Country:US
Mailing Address - Phone:301-593-7792
Mailing Address - Fax:301-593-1900
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE 227
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-593-7792
Practice Address - Fax:301-593-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD35791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE63777Medicare UPIN