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Individual

DR. LOUIS THAYER MERRIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
130 FISHER RD, SUITE 3-1, BERLIN, VT 05602-9516
(802) 225-7039
Mailing address
130 FISHER RD STE 3-1, BERLIN GENERAL SURGERY, BERLIN, VT 05602-9000
(802) 225-7039

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
042.0012371
VT
208600000X
Surgery Physician
Primary
212039
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01881158
NY
05
1020429
VT
01
5372668
AETNA
NY
01
77L071
EMPIRE BC.BS
NY
Enumeration date
07/18/2006
Last updated
11/11/2014
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