Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 827-025 | WI |
Y | 222Z00000X | Podiatrist | 827-025 | WI |
N | 213ES0103X | Foot & Ankle Surgery | 827-025 | WI |
N | 213ES0131X | Foot Surgery | 827 | WI |
NPI | 1073577854 |
---|---|
Provider Name | Steven J. Merckx |
First Address | Madison, WI 53719 |
Second Address | Madison, WI 53719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 11/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43231100 | (05) | WI |
U84567 | (02) |