Provider Demographics
NPI:1871694091
Name:MERRITT, WYNDELL HUNT (MD)
Entity type:Individual
Prefix:DR
First Name:WYNDELL
Middle Name:HUNT
Last Name:MERRITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7660 E PARHAM RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4378
Mailing Address - Country:US
Mailing Address - Phone:804-282-2112
Mailing Address - Fax:804-282-7133
Practice Address - Street 1:7660 E PARHAM RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4378
Practice Address - Country:US
Practice Address - Phone:804-282-2112
Practice Address - Fax:804-282-7133
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15121208200000X
VA01010264922082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
220987OtherOPTIMUM CHOICE
GA240007986OtherRAILROAD MEDICARE
AS07523600001OtherCIGNA HEALTHCARE
149330400OtherUS DEPARTMENT LABOR
220987OtherMAMSI
VA005673OtherANTHEM BX
0004137182OtherAETNA INSURANCE
42220OtherSOUTHERN HEALTH
VA6943420Medicaid
1300002OtherUNITED HEALTHCARE
149330400OtherUS DEPARTMENT LABOR
AS07523600001OtherCIGNA HEALTHCARE