Provider Demographics
NPI:1932176294
Name:ANSHER, MERRILL (MD)
Entity Type:Individual
Prefix:
First Name:MERRILL
Middle Name:
Last Name:ANSHER
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 1:11055 LITTLE PATUXENT PKWY
Mailing Address - Street 2:STE 209
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-884-0191
Mailing Address - Fax:510-997-2607
Practice Address - Street 1:11055 LITTLE PATUXENT PKWY
Practice Address - Street 2:STE 209
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-884-0191
Practice Address - Fax:510-997-2607
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD269762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D49809Medicare UPIN
MD588M930FMedicare ID - Type Unspecified