Merlin, Mark Louis

Merlin, Mark Louis is an sole proprietor health care provider with primary practice located at 2349 Lawrenceville Hwy , Decatur GA 30033-3143. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Merlin, Mark Louis can be contacted via phone (404) 320-1550.

Contact Information

Primary practice address
2349 Lawrenceville Hwy Decatur GA 30033-3143
Phone: (404) 320-1550
Fax: (404) 728-1081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 039178 Georgia
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 39178 Georgia

Profile Details

NPI number 1033193800
LBN Legal business name Merlin, Mark Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2005
Last updated Nov 3rd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033193800 NPPES
Georgia MEDICAID 165022770C

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