Provider Demographics
NPI:1487600821
Name:MERRICK, HOMER CURTISS (MD)
Entity type:Individual
Prefix:
First Name:HOMER
Middle Name:CURTISS
Last Name:MERRICK
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 1:458 HWY 70 EAST
Mailing Address - Street 2:
Mailing Address - City:SEALEVEL
Mailing Address - State:NC
Mailing Address - Zip Code:28577-0458
Mailing Address - Country:US
Mailing Address - Phone:252-225-1134
Mailing Address - Fax:252-225-1165
Practice Address - Street 1:458 HWY 70 EAST
Practice Address - Street 2:
Practice Address - City:SEALEVEL
Practice Address - State:NC
Practice Address - Zip Code:28577-0458
Practice Address - Country:US
Practice Address - Phone:252-225-1134
Practice Address - Fax:252-225-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP01519425OtherRAILROAD MEDICARE
NC891224PMedicaid
NC891224PMedicaid
NCP01519425OtherRAILROAD MEDICARE
NC110235054OtherRAILROAD MCR #
MDE09085Medicare UPIN