Provider Demographics
NPI:1356597850
Name:MERICK, RUDOLPH EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:EDWARD
Last Name:MERICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BEECH HILLS RD
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-6601
Mailing Address - Country:US
Mailing Address - Phone:724-527-2773
Mailing Address - Fax:
Practice Address - Street 1:24 BEECH HILLS RD
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-6601
Practice Address - Country:US
Practice Address - Phone:724-527-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA56QW5151207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine