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Ethan Zachariah Merrow
Student in an Organized Health Care Education/Training Program in Dacula, Georgia
NPI 1053820282

Ethan Zachariah Merrow is a Student in an Organized Health Care Education/Training Program based in Dacula, GA. Ethan Zachariah Merrow practices in Dacula, GA. The NPI Number for Ethan Zachariah Merrow is 1053820282 and holds a License No. (Georgia).

The current practice location address for Ethan Zachariah Merrow is 1701 Mulberry Lake Drive, Dacula, GA and can be reached out via phone at 770-712-4910.

Location: 1701 Mulberry Lake Drive, Dacula, GA, 30019-4642
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053820282
Provider Name
Ethan Zachariah Merrow
Credential
Provider Entity Type
Individual
Gender
Male
Address
1701 Mulberry Lake Drive, Dacula, GA, 30019-4642
Phone Number
770-712-4910
Fax Number
Provider Enumeration Date
09/20/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
390200000X 01 CHRIS LINKER ATC LAT
institution
Provider Business Practice Location Address Details
Address
1701 Mulberry Lake Drive
City
Dacula
State
Georgia
Zip
30019
Phone Number
770-712-4910
Fax Number
person
Provider Business Mailing Address Details
Address
1701 Mulberry Lake Drive
City
Dacula
State
Georgia
Zip
30019
Phone Number
770-712-4910
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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