Provider Demographics
NPI:1386604999
Name:DUNLAP, MERRITT W (MD)
Entity type:Individual
Prefix:DR
First Name:MERRITT
Middle Name:W
Last Name:DUNLAP
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 1:412 W JOHN ST STE D
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-8829
Mailing Address - Country:US
Mailing Address - Phone:775-461-0021
Mailing Address - Fax:775-461-0040
Practice Address - Street 1:412 W JOHN ST STE D
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-8829
Practice Address - Country:US
Practice Address - Phone:775-461-0021
Practice Address - Fax:775-461-0040
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG89736Medicare UPIN
31810Medicare ID - Type Unspecified
NV002013263Medicaid