MEDICARE: DR. SAMUEL K MERKHAN 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	209006	NY

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	:	1982691580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL K MERKHAN MD

Provider Business Mailing Address
First Line	:	949 COLUMBIA ST
Second Line	:
City	:	HUDSON
State	:	NY
Zip	:	12534-2624
Country	:	US
Telephone Number	:	518-828-7188
Fax Number	:	518-828-5049

Provider Business Practice Location Address
First Line	:	159 JEFFERSON HTS
Second Line	:	SUITE D107
City	:	CATSKILL
State	:	NY
Zip	:	12414-1237
Country	:	US
Telephone Number	:	518-943-1442
Fax Number	:	518-943-2003

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	11/06/2007

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