Individual
STEPHEN L MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3524 E MILWAUKEE ST, JANESVILLE, WI 53546-1626
(608) 756-7100
(608) 756-4700
Mailing address
3524 E MILWAUKEE ST, JANESVILLE, WI 53546-1626
(608) 756-7100
(608) 756-4700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036049241
IL
207Q00000X
Family Medicine Physician
036049241
IL
207Q00000X
Family Medicine Physician
51728
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036049241
—
IL
01
—
215652
MEDICARE GROUP #
—
01
—
553180
MEDICARE GROUP
IL
01
—
553180
MEDICARE #
—
01
—
834340
MEDICARE GROUP #
—
01
—
MERRISTE
MERCYCARE INSURANCE
WI
01
—
P00612688CD3624
RR MEDICARE
WI
Enumeration date
07/13/2006
Last updated
11/14/2011
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