Provider Demographics
NPI:1144450461
Name:MERVES, JAMIE FARRAH (MD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:FARRAH
Last Name:MERVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34TH ST. & CIVIC CENTER BLVD
Mailing Address - Street 2:DIVISION OF GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4399
Mailing Address - Country:US
Mailing Address - Phone:215-590-3630
Mailing Address - Fax:215-590-3606
Practice Address - Street 1:34TH ST. & CIVIC CENTER BLVD
Practice Address - Street 2:DIVISION OF GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-3630
Practice Address - Fax:215-590-3606
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195396208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics