MEDICARE: KERI ERLAND 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	207R00000X	Internal Medicine Physician	M6886	ID

General Provider Information

NPI Number	:	1922059146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI ERLAND MD

Provider Business Mailing Address
First Line	:	3667 N LOCUST GROVE RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-5924
Country	:	US
Telephone Number	:	208-939-9090
Fax Number	:	208-939-9911

Provider Business Practice Location Address
First Line	:	3667 N LOCUST GROVE RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-5924
Country	:	US
Telephone Number	:	208-939-9090
Fax Number	:	208-939-9911

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	02/26/2021

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Directions to “ KERI ERLAND MD” Practice Location

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