Provider Demographics
NPI:1811908023
Name:MERZOUK, MARIA D (DO)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:D
Last Name:MERZOUK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 MEDICAL CAMPUS RD STE 249
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6756
Mailing Address - Country:US
Mailing Address - Phone:301-714-4100
Mailing Address - Fax:301-714-4101
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 249
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6756
Practice Address - Country:US
Practice Address - Phone:301-714-4100
Practice Address - Fax:301-714-4101
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2181207VX0201X
MDH85851207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005936Medicaid
WVM6034581Medicare PIN
WV3810005936Medicaid