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Individual

MERRILL B MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 EAST MAIN STREET, WAYNESBORO, PA 17268
(717) 765-4000
(717) 765-3447
Mailing address
501 EAST MAIN ST, WAYNESBORO, PA 17268
(717) 765-3400
(717) 765-3408

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD035052E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1364074
HIGHMARK BLUE SHIELD
PA
05
20015310
PA
01
2056466000
INDEPENDENCE BLUE CROSS
PA
01
930088503
MEDICARE RAILROAD
Enumeration date
10/05/2006
Last updated
01/02/2008
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