Provider Demographics
NPI:1811944754
Name:MERCHANT, GULZAR A (MD)
Entity type:Individual
Prefix:
First Name:GULZAR
Middle Name:A
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:
Practice Address - Street 1:255 ENTERPRISE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6300
Practice Address - Country:US
Practice Address - Phone:864-454-2270
Practice Address - Fax:864-454-2279
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC18796207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00801505OtherRR MEDICARE
SC187960Medicaid
SC576007863123OtherBLUE CHOICE OF SC
SC110209701OtherRR MEDICARE
SC110209701OtherRR MEDICARE
SC187960Medicaid