Provider Demographics
NPI:1821829805
Name:MERKEL, MATTHEW COLLIN
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:COLLIN
Last Name:MERKEL
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 1:216 PORTIER CT E APT C
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-2260
Mailing Address - Country:US
Mailing Address - Phone:678-740-2961
Mailing Address - Fax:
Practice Address - Street 1:216 PORTIER CT E APT C
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2260
Practice Address - Country:US
Practice Address - Phone:678-740-2961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program