Provider Demographics
NPI:1609887462
Name:MERRITT, MICHAEL V (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:V
Last Name:MERRITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15212 W 91ST TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1142
Mailing Address - Country:US
Mailing Address - Phone:913-299-4442
Mailing Address - Fax:913-299-4442
Practice Address - Street 1:15212 W 91ST TER
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1142
Practice Address - Country:US
Practice Address - Phone:913-299-4442
Practice Address - Fax:913-299-4442
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00111530OtherRAILROAD MEDICARE
KS09852013OtherBCBS OF KANSAS CITY
KS452435OtherAETNA
KS0001166Medicare ID - Type Unspecified