Individual
DR. MERYL A SEVERSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 W 8TH AVE, SUITE 200, SPOKANE, WA 99204-2302
(509) 624-9112
(509) 624-1087
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
32709
IA
207T00000X
Neurological Surgery Physician
MD436241
PA
207T00000X
Neurological Surgery Physician
Primary
MD60693605
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70337
WELLMARK BCBS
IA
Enumeration date
05/17/2007
Last updated
04/26/2017
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