Provider Demographics
NPI:1013009604
Name:MERKEL, LAWRENCE ALAN (MD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ALAN
Last Name:MERKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2121 E HARMONY RD
Mailing Address - Street 2:STE 370
Mailing Address - City:FT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3404
Mailing Address - Country:US
Mailing Address - Phone:970-221-2290
Mailing Address - Fax:970-295-0036
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:STE 370
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3404
Practice Address - Country:US
Practice Address - Phone:970-221-2290
Practice Address - Fax:970-295-0036
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO19158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01191584Medicaid
D23554Medicare UPIN
CO01191584Medicaid