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Individual

TAYLOR GRANT MERTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
801 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 364-6800
(218) 233-9267
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(218) 364-6800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13729
ND
207Q00000X
Family Medicine Physician
Primary
59493
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285926360
WI
Enumeration date
05/09/2011
Last updated
12/24/2015
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