Provider Demographics
NPI:1326477795
Name:STEVEN L MERRILL MD PC
Entity Type:Organization
Organization Name:STEVEN L MERRILL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-376-2263
Mailing Address - Street 1:421 N OREM BLVD
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-8813
Mailing Address - Country:US
Mailing Address - Phone:801-764-0200
Mailing Address - Fax:
Practice Address - Street 1:421 N OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-8813
Practice Address - Country:US
Practice Address - Phone:801-764-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty