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General NPI Number Information
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NPI Number | 1770528473
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Entity Type | Organization
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Legal Business Name | CONVENIENT MEDICAL CARE, PC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 319 BAY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-1402
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Country | US
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Telephone | 518-792-2181
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Fax | 518-792-1531
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Provider Business Mailing Address
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Address Line | 319 BAY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-1402
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Country | US
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Telephone | 518-792-2181
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Fax | 518-792-1531
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Authorized Official
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Title or Position | DOCTOR/PHYSICIAN
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Name | DR. DONALD REYNOLDS MERRIHEW JR.
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Credential | M.D.
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Telephone | 518-792-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 148341-1
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License Number State | NY
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