MEDICARE: DR. MICHAEL EDWARD MERHIGE M.D.

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	207RC0000X	Cardiovascular Disease Physician	177176	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA1675	OTHER	NY	PTAN
2	DD6365	OTHER	NY	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	RA0987	OTHER	NY	PTAN

General Provider Information

NPI Number	:	1902887128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL EDWARD MERHIGE M.D.

Provider Business Mailing Address
First Line	:	2447 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-9405
Country	:	US
Telephone Number	:	716-835-1545
Fax Number	:	716-835-1580

Provider Business Practice Location Address
First Line	:	2447 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-9405
Country	:	US
Telephone Number	:	716-835-1545
Fax Number	:	716-835-1580

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	11/19/2015

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