Provider Demographics
NPI:1669470795
Name:REUTER, MERRILL WAYNE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MERRILL
Middle Name:WAYNE
Last Name:REUTER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 PRINCETON DRIVE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9353
Mailing Address - Country:US
Mailing Address - Phone:561-939-6325
Mailing Address - Fax:561-899-0460
Practice Address - Street 1:7138 LAKE WORTH RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2970
Practice Address - Country:US
Practice Address - Phone:561-939-6325
Practice Address - Fax:561-899-0460
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054695174400000X, 207XS0117X, 207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No174400000XOther Service ProvidersSpecialist
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
14577ZMedicare PIN
FLD67607Medicare UPIN