Individual
DR. KENNETH S MERRIMAN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 COOK RD, HASTINGS, MI 49058-9616
(269) 945-9520
(269) 945-3368
Mailing address
PO BOX 290, HASTINGS, MI 49058-0290
(269) 945-9520
(269) 945-3368
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301035154
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101378087
—
MI
01
—
200005744
RAILROAD MEDICARE
MI
01
—
200Z800130
BCBS
MI
01
—
540Z810220
DME WITH BCBS
MI
01
—
874704973
DME WITH MEDICAID
MI
Enumeration date
06/29/2006
Last updated
03/25/2008
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