Individual
DR. BRYCE ALLEN MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
MD201416
OR
2085B0100X
Body Imaging Physician
MD61044567
WA
2085R0202X
Diagnostic Radiology Physician
Primary
4301507237
MI
2085R0202X
Diagnostic Radiology Physician
MD201416
OR
2085R0202X
Diagnostic Radiology Physician
MD61044567
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0423345
L&I-TRA-REST OF WA
WA
01
—
0423347
L&I-TRA-KING
WA
01
—
0423349
L&I-UNION AVENUE OPEN MRI
WA
01
—
0423350
L&I-DIANOSTIC IMAGING NW
WA
05
—
2156677
—
WA
05
—
500793064
—
OR
Enumeration date
04/10/2014
Last updated
09/01/2022
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