Provider Demographics
NPI:1710993258
Name:MERKLE, PETER F (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:F
Last Name:MERKLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5113
Mailing Address - Country:US
Mailing Address - Phone:954-783-7100
Mailing Address - Fax:954-783-7304
Practice Address - Street 1:1101 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5104
Practice Address - Country:US
Practice Address - Phone:954-783-7100
Practice Address - Fax:954-783-7304
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51275207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05996OtherBLUE SHIELD
FL05996OtherBLUE SHIELD
E21531Medicare UPIN
FLK3690Medicare PIN