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Individual

DR. MERYL ELIZABETH ETHRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(586) 573-8030
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036171376
IL
208600000X
Surgery Physician
Primary
4301517811
MI
2086S0127X
Trauma Surgery Physician
336126563
IL

Other

Enumeration date
05/07/2018
Last updated
07/27/2026
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