MEDICARE: DAKOTA MERKEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1073322418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA MERKEL

Provider Business Mailing Address
First Line	:	17658 SUMMERHILL LN
Second Line	:
City	:	NEW BUFFALO
State	:	MI
Zip	:	49117-9215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 UNIVERSITY BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5147
Country	:	US
Telephone Number	:	219-363-0577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	12/31/2024

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Directions to “ DAKOTA MERKEL ” Practice Location

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