Provider Demographics
NPI:1982690186
Name:MERTA, STEVEN R
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:R
Last Name:MERTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21000
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-0210
Mailing Address - Country:US
Mailing Address - Phone:828-328-2901
Mailing Address - Fax:828-327-6223
Practice Address - Street 1:1205 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3759
Practice Address - Country:US
Practice Address - Phone:828-328-2901
Practice Address - Fax:828-327-6223
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700669207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891059Medicaid
NCBM3448328OtherDEA
NCBM3448328OtherDEA
F77344Medicare UPIN