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Individual

DR. JOSEPH1940 HARRY MERICKEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1109 MAPLE ST, ALEXANDRIA, MN 56308-2626
(320) 763-4906
Mailing address
1109 MAPLE ST, ALEXANDRIA, MN 56308-2626
(320) 763-4906

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17363
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17363
LICENSE TO PRACTICE MEDIC
MN
Enumeration date
05/29/2007
Last updated
07/08/2007
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