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General NPI Number Information
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NPI Number | 1780667907
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Entity Type | Individual
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Provider Name | BRUCE J. MERKIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 15251 PLEASANT VALLEY RD
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City | CENTER CITY
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State | MN
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Zip | 55012-9640
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Country | US
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Telephone | 800-257-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 15251 PLEASANT VALLEY RD
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City | CENTER CITY
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State | MN
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Zip | 55012-9640
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Country | US
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Telephone | 800-257-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 35-086596
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License Number State | OH
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