Macgaw, Douglas Merritt

Macgaw, Douglas Merritt is an individual health care provider with primary practice located at 2860 Covington Pike , Memphis TN 38128-8090. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Macgaw, Douglas Merritt can be contacted via phone (901) 252-6034.

Contact Information

Primary practice address
2860 Covington Pike Memphis TN 38128-8090
Fax: (901) 252-6048
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 07103 Tennessee
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 07103 Tennessee

Profile Details

NPI number 1922092949
LBN Legal business name Macgaw, Douglas Merritt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Oct 13th, 2014 - 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 1922092949 NPPES
Tennessee MEDICAID 3159338

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