Provider Demographics
NPI:1447546189
Name:MERRILL, AMELIA Y (MD)
Entity type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:Y
Last Name:MERRILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMELIA
Other - Middle Name:CATE
Other - Last Name:YOUNKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6324 FAIRVIEW RD STE 420
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3372
Practice Address - Country:US
Practice Address - Phone:980-302-8840
Practice Address - Fax:980-302-8865
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-10561208600000X
NC2018-01300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery