Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 33308 | MN |
NPI | 1033199328 |
---|---|
Provider Name | Michael P Merck |
First Address | Hutchinson, MN 55350-0699 |
Second Address | Hutchison, MN 55350-0699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 16/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
279700300 | (05) | MN |
E57110 | (02) | MN |