MEDICARE: MERRILL N WORKHOVEN MD

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	207L00000X	Anesthesiology Physician	MD08982	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821041369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRILL N WORKHOVEN MD

Provider Business Mailing Address
First Line	:	PO BOX 349
Second Line	:	1860 VIRGINIA AVE SUITE 9
City	:	NORTH BEND
State	:	OR
Zip	:	97459-0106
Country	:	US
Telephone Number	:	541-756-2070
Fax Number	:	541-756-1999

Provider Business Practice Location Address
First Line	:	1775 THOMPSON RD
Second Line	:
City	:	COOS BAY
State	:	OR
Zip	:	97420-2125
Country	:	US
Telephone Number	:	541-269-8020
Fax Number	:

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/09/2007

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Directions to “ MERRILL N WORKHOVEN MD” Practice Location

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