Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 35-086596 | OH |
NPI | 1780667907 |
---|---|
Provider Name | Dr. Bruce J. Merkin |
First Address | Youngstown, OH 44509-1227 |
Second Address | Youngstown, OH 44509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 23/10/2019 |